1730171372 NPI number — ESTHER S. VOGEL PA-C

Table of content: ESTHER S. VOGEL PA-C (NPI 1730171372)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730171372 NPI number — ESTHER S. VOGEL PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VOGEL
Provider First Name:
ESTHER
Provider Middle Name:
S.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VOGEL-SPERBER
Provider Other First Name:
ESTEE
Provider Other Middle Name:
S.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730171372
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8181 NW 154TH ST STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI LAKES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33016-5861
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-558-3724
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21150 BISCAYNE BLVD.
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
AVENTURA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33180
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-935-6000
Provider Business Practice Location Address Fax Number:
305-935-6248
Provider Enumeration Date:
08/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  002306 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: PA9105100 , 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)

  • Identifier: 000033976 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 024817600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com