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General NPI Number Information
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NPI Number | 1891778825
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Entity Type | Individual
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Provider Name | ROBERT S FOGARTY DC
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Gender | Male
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 02/28/2014
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Provider Practice Location Address
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Address Line | 12484 LAKE UNDERHILL RD
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City | ORLANDO
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State | FL
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Zip | 32828-7100
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Country | US
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Telephone | 407-281-0707
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Fax | 407-273-4793
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Provider Business Mailing Address
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Address Line | 12484 LAKE UNDERHILL RD
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City | ORLANDO
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State | FL
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Zip | 32828-7100
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Country | US
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Telephone | 407-281-0707
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Fax | 407-273-4793
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH0006917
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License Number State | FL
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