Provider Demographics
NPI:1568955300
Name:ROGOZINSKI, ELIZABETH USEDOM (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:USEDOM
Last Name:ROGOZINSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:JOAN
Other - Last Name:USEDOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14275 N 87TH ST STE 109-110
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3696
Mailing Address - Country:US
Mailing Address - Phone:480-905-8485
Mailing Address - Fax:480-905-7274
Practice Address - Street 1:915 W MONROE ST STE 300
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-1177
Practice Address - Country:US
Practice Address - Phone:904-903-4345
Practice Address - Fax:904-903-4347
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL162032207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology