Individual
GEORGETTE ROGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2678 SW ACE RD, PORT SAINT LUCIE, FL 34953-2815
(954) 907-8393
Mailing address
2678 SW ACE RD, PORT SAINT LUCIE, FL 34953-2815
(954) 907-8393
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
1075541
FL
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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