Provider Demographics
NPI:1013913383
Name:TROGOLO, FRANK E (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:E
Last Name:TROGOLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14540 OLD SAINT AUGUSTINE RD STE 2391
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-7418
Mailing Address - Country:US
Mailing Address - Phone:904-647-6946
Mailing Address - Fax:844-473-3117
Practice Address - Street 1:14540 OLD SAINT AUGUSTINE RD STE 2391
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258
Practice Address - Country:US
Practice Address - Phone:904-647-6946
Practice Address - Fax:844-473-3117
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 89602207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270353000Medicaid
FL43275YMedicare PIN
FL270353000Medicaid