Provider Demographics
NPI:1699138909
Name:ROGOZINSKI, JONATHAN (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:ROGOZINSKI
Suffix:
Gender:
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 STE 3
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4318
Mailing Address - Country:US
Mailing Address - Phone:904-733-3529
Mailing Address - Fax:904-730-7687
Practice Address - Street 1:3716 UNIVERSITY BLVD S STE 3
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4318
Practice Address - Country:US
Practice Address - Phone:904-733-3529
Practice Address - Fax:904-730-7687
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME160609207X00000X
AZ65740207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery