Provider Demographics
NPI:1316262934
Name:SOUTH FLORIDA INTERVENTIONAL RADIOLOGY PA
Entity type:Organization
Organization Name:SOUTH FLORIDA INTERVENTIONAL RADIOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-724-7636
Mailing Address - Street 1:5223 N BAY RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2010
Mailing Address - Country:US
Mailing Address - Phone:305-724-7636
Mailing Address - Fax:954-345-7194
Practice Address - Street 1:4302 ALTON RD
Practice Address - Street 2:SUITE 320
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2891
Practice Address - Country:US
Practice Address - Phone:305-724-7636
Practice Address - Fax:954-345-7194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty