Provider Demographics
NPI:1154552487
Name:ROGERS, LAUREN ELIZABETH (DPT)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:ROGERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3577 LAKE EMMA RD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2056
Mailing Address - Country:US
Mailing Address - Phone:407-936-0314
Mailing Address - Fax:
Practice Address - Street 1:3577 LAKE EMMA RD
Practice Address - Street 2:SUITE 121
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2056
Practice Address - Country:US
Practice Address - Phone:407-936-0314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35182225100000X
FL24827225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist