Provider Demographics
NPI:1255653887
Name:VOGTCHIROPRACTIC, PLC
Entity Type:Organization
Organization Name:VOGTCHIROPRACTIC, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:VOGT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-365-8300
Mailing Address - Street 1:1755 W BROADWAY ST
Mailing Address - Street 2:STE 4
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-4201
Mailing Address - Country:US
Mailing Address - Phone:407-365-8300
Mailing Address - Fax:407-359-2165
Practice Address - Street 1:1755 W BROADWAY ST
Practice Address - Street 2:STE 4
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-4201
Practice Address - Country:US
Practice Address - Phone:407-365-8300
Practice Address - Fax:407-359-2165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH006063111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380329500Medicaid
FL380329500Medicaid
FL22514Medicare PIN