Provider Demographics
NPI:1215034574
Name:CHARLES L VOGEL, M.D., P.A.
Entity Type:Organization
Organization Name:CHARLES L VOGEL, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-473-6776
Mailing Address - Street 1:2000 S OCEAN BLVD
Mailing Address - Street 2:APT 4-B
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-8535
Mailing Address - Country:US
Mailing Address - Phone:954-473-6776
Mailing Address - Fax:954-473-6590
Practice Address - Street 1:350 NW 84TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1817
Practice Address - Country:US
Practice Address - Phone:954-473-6776
Practice Address - Fax:954-473-6590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0031405174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty