Healthcare Provider Details

I. General information

NPI: 1801718036
Provider Name (Legal Business Name): MICHAELA BOGLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 SW 9TH ST APT 1
POMPANO BEACH FL
33060-8247
US

IV. Provider business mailing address

10777 W SAMPLE RD APT 811
CORAL SPRINGS FL
33065-3771
US

V. Phone/Fax

Practice location:
  • Phone: 954-684-8170
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: