Provider Demographics
NPI:1386978328
Name:HAGELBERGER, ROGER (RNCST,CFCE)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:
Last Name:HAGELBERGER
Suffix:
Gender:M
Credentials:RNCST,CFCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 PORT ROYALE DR N
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-7919
Mailing Address - Country:US
Mailing Address - Phone:954-748-7474
Mailing Address - Fax:954-748-7772
Practice Address - Street 1:4486 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-4513
Practice Address - Country:US
Practice Address - Phone:954-748-7474
Practice Address - Fax:954-748-7772
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic