Individual
TYLASHEA EVANS ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
811 E ROSEWOOD LN, TAVARES, FL 32778-5109
(352) 702-2252
Mailing address
811 E ROSEWOOD LN, TAVARES, FL 32778-5109
(352) 702-2252
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104959200
—
FL
Enumeration date
11/29/2022
Last updated
11/29/2022
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