Healthcare Provider Details

I. General information

NPI: 1104071588
Provider Name (Legal Business Name): SYLVIA JOANNA ROZEK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2008
Last Update Date: 02/02/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MERCADO ST STE 202
DURANGO CO
81301-7307
US

IV. Provider business mailing address

4674 BRITTON PARKWAY
HILLIARD OH
43026
US

V. Phone/Fax

Practice location:
  • Phone: 970-764-9400
  • Fax: 970-764-9446
Mailing address:
  • Phone: 614-210-4530
  • Fax: 614-210-4539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number35-096937
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberDR.0065137
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: