Healthcare Provider Details

I. General information

NPI: 1730008509
Provider Name (Legal Business Name): TIMOTHY VOGT PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4161 TAMIAMI TRL STE 401
PORT CHARLOTTE FL
33952-9254
US

IV. Provider business mailing address

2504 N 124TH ST APT 116
WAUWATOSA WI
53226-1039
US

V. Phone/Fax

Practice location:
  • Phone: 941-235-2710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number2261875
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: