Provider Demographics
NPI:1104803436
Name:ROGOFF, MICHAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:ROGOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:400 W 41ST ST STE 310
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3524
Mailing Address - Country:US
Mailing Address - Phone:305-763-8734
Mailing Address - Fax:786-522-1972
Practice Address - Street 1:400 W 41ST ST STE 310
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3524
Practice Address - Country:US
Practice Address - Phone:305-763-8734
Practice Address - Fax:786-522-1972
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 761542085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261145701Medicaid
FL261145701Medicaid
FL58873VMedicare PIN