Provider Demographics
NPI:1942628649
Name:VOGT, BRITTANY J (PA-C)
Entity Type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:J
Last Name:VOGT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:J
Other - Last Name:GAGNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 S HARBOUR ISLAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5925
Mailing Address - Country:US
Mailing Address - Phone:863-215-6639
Mailing Address - Fax:844-388-6186
Practice Address - Street 1:5051 SE 110TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVIEW
Practice Address - State:FL
Practice Address - Zip Code:34420-3115
Practice Address - Country:US
Practice Address - Phone:352-674-1730
Practice Address - Fax:352-674-8930
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9107324363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHU580ZMedicare UPIN