Provider Demographics
NPI:1457843369
Name:OGRODNIK, ROSIE M SR
Entity Type:Individual
Prefix:
First Name:ROSIE
Middle Name:M
Last Name:OGRODNIK
Suffix:SR
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4028 NAVIGATOR WAY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-1824
Mailing Address - Country:US
Mailing Address - Phone:407-508-5357
Mailing Address - Fax:
Practice Address - Street 1:4028 NAVIGATOR WAY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-1824
Practice Address - Country:US
Practice Address - Phone:407-508-5357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver