Doctor Name: | RANDALL JAMES ROGERS |
NPI Number: | 1083741722 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C, LMT |
License Number: | MA58093 |
Business Practice Address: | 2898 S Osceola Ave Orlando, FL - 328065461 |
Business Phone Number: | 4078128110 |
Business Fax Number: | 4078128109 |
Mailing Address: | 3742 Gatlin Woods Dr, ORLANDO |
State: | FL |
Postal Code: | 328127610 |
Phone Number: | 4077165391 |
Fax Number: | |
NPI Enumeration Date: | 02/28/2007 |
NPI Last Update Date: | 08/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA58093 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |