Healthcare Provider Details

I. General information

NPI: 1295982320
Provider Name (Legal Business Name): ROBERT VOGT-LOWELL MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 08/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7765 SW 87TH AVE SUITE 110
MIAMI FL
33173-2596
US

IV. Provider business mailing address

7765 SW 87TH AVE SUITE 110
MIAMI FL
33173-2535
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-1833
  • Fax:
Mailing address:
  • Phone: 305-595-1833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberME65232
License Number StateFL

VIII. Authorized Official

Name: MR. RICK MARCOS
Title or Position: ADMINISTRATOR
Credential:
Phone: 305-975-5516