Provider Demographics
NPI:1447579826
Name:VOGT, MICHAEL LEWIS (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:LEWIS
Last Name:VOGT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8075 SW HIGHWAY 200 UNIT 118
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-7823
Mailing Address - Country:US
Mailing Address - Phone:352-414-4511
Mailing Address - Fax:844-388-6186
Practice Address - Street 1:8075 SW HIGHWAY 200 UNIT 118
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-7823
Practice Address - Country:US
Practice Address - Phone:352-414-4511
Practice Address - Fax:844-388-6186
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME115066207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHV581ZMedicare PIN