Lake Women for Women OB/GYN,LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

LAKE WOMEN FOR WOMEN OB/GYN,LLC

Practice address

2 N Eustis St
Eustis, FL 32726-3408

Phone

(352) 589-6005

Fax

(352) 484-0189

NPI assigned

Mar 22, 2012

Last updated

Mar 22, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mamie Rogers, MDNPI 1912190505

Title

Owner

Phone

(352) 589-6005

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mamie Mesie Rogers, M.D.

  • Obstetrics & Gynecology Physician
  • Tavares, FL
  • NPI 1912190505
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332374400000",
    "number": "1043585169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327780780",
            "telephone_number": "352-589-6005",
            "fax_number": "352-484-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N EUSTIS ST",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327263408",
            "telephone_number": "352-589-6005",
            "fax_number": "352-484-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE WOMEN FOR WOMEN OB/GYN,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-22",
        "last_updated": "2012-03-22",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "MAMIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-589-6005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Eustis, FL
• Providers in Eustis, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.