REHABILITATION CONSULTANTS PA
Psychiatric at Doctors Way, Fort Myers, FL

License number
Florida OS6278
Category
Psychiatric
Type
Pain Medicine
Owner
Name: DR. DEBRA K ROGGOW D.O.
Title: PRESIDENT
Phone: (239) 768-5454
Address
Address
13685 Doctors Way STE 190, Fort Myers, FL 33912
National Provider ID: 1699947465
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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REHABILITATION CONSULTANTS, PA

Fort Myers, FL

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Jan 20, 1993
Inactive since:
Sep 27, 2013
Addresses:
11588 Mahogany Run, Fort Myers, FL 33913 (Physical)
PO Box 60013, Fort Myers, FL 33906
State ID:
P93000004601
Business type:
Florida Profit Corporation
President, Directors:
Debra Kdr. Roggow President, Director, Vice President, inactive, 11588 Mahogany Run, Fort Myers, FL 33913 (Physical),Vidya P. Kini President, Director, inactive
Agent:
Debra Roggow,11588 Mahogany Run, Fort Myers, FL 33913 (Physical)
EIN:
650382275

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