Organization
LAKESIDE DERMATOLOGY LLC
Active
Organization
LAKESIDE DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOSEPH ROGERS MD (SOLE MBR)
(863) 385-7183
Entity
Organization
Contact information
Practice address
727 US 27 S, SEBRING, FL 33870-2169
(863) 385-7183
(863) 385-0088
Mailing address
727 US 27 S, SEBRING, FL 33870-2169
(863) 385-7183
(863) 385-0088
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME0058778
FL
207NS0135X
Procedural Dermatology Physician
ME0058778
FL
Other
Enumeration date
09/11/2008
Last updated
12/19/2024
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