Healthcare Provider Details

I. General information

NPI: 1801395256
Provider Name (Legal Business Name): EMILY VOGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2018
Last Update Date: 02/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E OAK AVE
TAMPA FL
33602-2210
US

IV. Provider business mailing address

871 IBIS WALK PL N UNIT 9304
ST PETERSBURG FL
33716-3828
US

V. Phone/Fax

Practice location:
  • Phone: 813-224-9622
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: