Provider Demographics
NPI:1164741708
Name:VOGEL, CAROL A (LMT)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:VOGEL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14259 GNATCATCHER TER
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-8272
Mailing Address - Country:US
Mailing Address - Phone:941-224-2493
Mailing Address - Fax:
Practice Address - Street 1:14259 GNATCATCHER TER
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-8272
Practice Address - Country:US
Practice Address - Phone:941-224-2493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL55721225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist