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ROXANNE DONNA-SHEA BOGALIS
>> Community Health Worker >> Other Service ProvidersRegistrant NPI Number: 1285108548
Individual Registrant: ROXANNE DONNA-SHEA BOGALIS
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
14530 CALLEN GLEN WAY WIMAUMA, FL 33598-6180 US
Tel: 941-769-1650 Fax: --
Tel: 941-769-1650 Fax: --
Contact information for business:
14530 CALLEN GLEN WAY WIMAUMA, FL 33598-6180 US
Tel: 941-769-1650 Fax: --
Tel: 941-769-1650 Fax: --
Registration Information:
NPI: 1285108548
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 172V00000X | Other Service Providers Community Health Worker | ||
| N | 174N00000X | |||
| N | 374J00000X | |||
| Y | 174H00000X |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
