Individual
CHERYL ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
911 S MAIN ST, TRENTON, FL 32693-3239
(352) 463-6292
(352) 463-4507
Mailing address
PO BOX 100296, GAINESVILLE, FL 32610-0296
(352) 627-9350
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0064448
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
373157000
MEDICAID
FL
01
—
68629
BLUE CROSS
FL
01
—
ME0064448
FL MEDICAL LICENSE
FL
Enumeration date
07/27/2006
Last updated
06/01/2021
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