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General NPI Number Information
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NPI Number | 1114505195
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Entity Type | Individual
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Provider Name | FREDERICK CARON HOGAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2021
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 11375 CORTEZ BOULEVARD, SR50
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City | BROOKSVILLE
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State | FL
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Zip | 34613
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Country | US
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Telephone | 352-592-2755
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Fax | 352-597-6173
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Provider Business Mailing Address
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Address Line | 11375 CORTEZ BOULEVARD, SR 50
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City | BROOKSVILLE
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State | FL
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Zip | 34613
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Country | US
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Telephone | 407-864-8446
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0101287401
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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