Healthcare Provider Details

I. General information

NPI: 1104803436
Provider Name (Legal Business Name): MICHAEL A ROGOFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 41ST ST STE 310
MIAMI BEACH FL
33140-3524
US

IV. Provider business mailing address

400 W 41ST ST STE 310
MIAMI BEACH FL
33140-3524
US

V. Phone/Fax

Practice location:
  • Phone: 305-763-8734
  • Fax: 786-522-1972
Mailing address:
  • Phone: 305-763-8734
  • Fax: 786-522-1972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberME 76154
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: