Individual
ROGER S KOERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 JUPITER LAKES BLVD, SUITE 106, BLDG 3000, JUPITER, FL 33458-7191
(561) 401-9082
(561) 401-9251
Mailing address
210 JUPITER LAKES BLVD, SUITE 106, BLDG 3000, JUPITER, FL 33458-7191
(561) 401-9082
(561) 401-9251
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME0032452
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50860
BC/BS INDIV PROVIDER NUM
FL
01
—
99485
BC/BS GROUP PROVIDER NUM
FL
Enumeration date
10/20/2006
Last updated
07/06/2012
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