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General NPI Number Information
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NPI Number | 1124111760
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Entity Type | Individual
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Provider Name | MICHAEL JOHN HOGAN CPO/LPO
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 06/03/2015
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Provider Practice Location Address
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Address Line | 1731 S ORANGE AVE
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City | ORLANDO
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State | FL
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Zip | 32806-2935
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Country | US
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Telephone | 407-781-2360
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Fax | 407-781-2362
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Provider Business Mailing Address
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Address Line | 1731 S ORANGE AVE
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City | ORLANDO
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State | FL
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Zip | 32806-2935
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Country | US
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Telephone | 407-781-2360
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Fax | 407-781-2362
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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 | 224P00000X
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Taxonomy Name | Prosthetist
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License Number | CPO02315
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | CPO02315
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License Number State | FL
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