Individual
MARK ELIOT ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5865 N UNIVERSITY DR, TAMARAC, FL 33321-4617
(954) 234-4239
Mailing address
7154 N UNIVERSITY DR, STE103, TAMARAC, FL 33321-2916
(954) 234-4239
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3049
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620284500
—
FL
Enumeration date
07/13/2006
Last updated
07/08/2007
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