10D0940832 CLIA NUMBER - VICENTE E ROGER MD PA DBA MIAMI PEDIATRICS

Laboratory Demographics

CLIA Number: 10D0940832

Facility Name: VICENTE E ROGER MD PA DBA MIAMI PEDIATRICS

Facility Address:
1069 KANE CONCOURSE
BAY HARBOR ISLANDS, FL
ZIP 33154
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Facility Phone Number: 305 868-5181

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1033169602

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	10D0940832
LAB Type	Physician Office
Facility Name	VICENTE E ROGER MD PA DBA MIAMI PEDIATRICS
Street	1069 KANE CONCOURSE
City	BAY HARBOR ISLANDS
State	FL
ZIP	33154
Phone	305 868-5181
CertificateType	4
CertificateEffectiveDate	3/29/2023
CertificateExpirationDate	3/28/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024