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General NPI Number Information
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NPI Number | 1033232848
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Entity Type | Individual
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Provider Name | SAMUEL ROHAN OGLE MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2007
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Last Update Date | 03/08/2013
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Provider Practice Location Address
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Address Line | 70 FOX RIDGE CT STE B
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City | DEBARY
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State | FL
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Zip | 32713-2752
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Country | US
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Telephone | 407-409-8111
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Fax | 407-409-8115
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Provider Business Mailing Address
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Address Line | 321 MONTGOMERY RD #160965
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32716-7000
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Country | US
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Telephone | 407-409-8111
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Fax | 407-409-8115
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME98314
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License Number State | FL
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