Provider Demographics
NPI:1215224969
Name:VOGELI, MOLLY WELLS
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:WELLS
Last Name:VOGELI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 PENINSULA CORPORATE CIR
Mailing Address - Street 2:SUITE 1014
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1378
Mailing Address - Country:US
Mailing Address - Phone:561-994-6590
Mailing Address - Fax:561-994-6690
Practice Address - Street 1:950 PENINSULA CORPORATE CIR
Practice Address - Street 2:SUITE 1014
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1378
Practice Address - Country:US
Practice Address - Phone:561-994-6590
Practice Address - Fax:561-994-6690
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ5456235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003772500Medicaid
FLFF056ZMedicare PIN