Provider Demographics
NPI:1871778381
Name:ROGERS, RACHEL (SLP)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 BRICKELL AVE
Mailing Address - Street 2:APT. #1002
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1213
Mailing Address - Country:US
Mailing Address - Phone:305-984-3033
Mailing Address - Fax:305-858-2977
Practice Address - Street 1:1541 BRICKELL AVE
Practice Address - Street 2:APT. #1002
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-1213
Practice Address - Country:US
Practice Address - Phone:305-984-3033
Practice Address - Fax:305-858-2977
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9479235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL892633600Medicaid