Healthcare Provider Details

I. General information

NPI: 1558945014
Provider Name (Legal Business Name): KATHRYN CLAIRE VOGEL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2021
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 W MICHIGAN ST
ORLANDO FL
32806-4453
US

IV. Provider business mailing address

1650 S PENNSYLVANIA AVE
WINTER PARK FL
32789-5728
US

V. Phone/Fax

Practice location:
  • Phone: 407-650-9220
  • Fax:
Mailing address:
  • Phone: 772-233-1276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11010107
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: