Individual
CLARK D ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 200-2355
Mailing address
2600 WESTHALL LN FL 4, MAITLAND, FL 32751-7102
(407) 200-2355
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01071897A
IN
2085R0202X
Diagnostic Radiology Physician
Primary
ME122500
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201105730
—
IN
Enumeration date
06/23/2009
Last updated
04/11/2016
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