1215034574 NPI number — CHARLES L VOGEL, M.D., P.A.

Table of content: (NPI 1215034574)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215034574 NPI number — CHARLES L VOGEL, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHARLES L VOGEL, M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215034574
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 S OCEAN BLVD
Provider Second Line Business Mailing Address:
APT 4-B
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33432-8535
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-473-6776
Provider Business Mailing Address Fax Number:
954-473-6590

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
350 NW 84TH AVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
PLANTATION
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33324-1817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-473-6776
Provider Business Practice Location Address Fax Number:
954-473-6590
Provider Enumeration Date:
09/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HERNANDEZ
Authorized Official First Name:
NIDIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
954-473-6776

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  ME0031405 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)