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 1:11705 SAN JOSE BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-1653
Mailing Address - Country:US
Mailing Address - Phone:904-594-2755
Mailing Address - Fax:904-515-6437
Practice Address - Street 1:11705 SAN JOSE BLVD STE 210
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-1653
Practice Address - Country:US
Practice Address - Phone:904-594-2755
Practice Address - Fax:904-515-6437
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL162032207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology