Provider Demographics
NPI:1407031461
Name:MICHAEL A ROGOFF MD PA
Entity Type:Organization
Organization Name:MICHAEL A ROGOFF MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-672-9989
Mailing Address - Street 1:4302 ALTON RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2891
Mailing Address - Country:US
Mailing Address - Phone:305-672-9989
Mailing Address - Fax:305-672-8711
Practice Address - Street 1:4302 ALTON RD
Practice Address - Street 2:SUITE 300
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2891
Practice Address - Country:US
Practice Address - Phone:305-672-9989
Practice Address - Fax:305-672-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME761542085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL58873OtherBCBS#