Provider Demographics
NPI:1487641072
Name:ROGOZINSKI, CHAIM (MD)
Entity type:Individual
Prefix:DR
First Name:CHAIM
Middle Name:
Last Name:ROGOZINSKI
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 1:3716 UNIVERSITY BLVD S
Mailing Address - Street 2:SUITE 3
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4355
Mailing Address - Country:US
Mailing Address - Phone:904-733-3529
Mailing Address - Fax:904-730-7687
Practice Address - Street 1:3716 UNIVERSITY BLVD S
Practice Address - Street 2:SUITE 3
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4355
Practice Address - Country:US
Practice Address - Phone:904-733-3529
Practice Address - Fax:904-730-7687
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL015053 - AAOS ID#207X00000X
FLMEFL0036117207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Not Answered207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL04034OtherBLUE CROSS BLUE SHIELD ID
FL1715140-001OtherCIGNA PPO ID#
FLD50906Medicare UPIN