Provider Demographics
NPI:1144298829
Name:VOGEL, CRAIG D (DO)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:D
Last Name:VOGEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 UNIVERSITY BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-2775
Mailing Address - Country:US
Mailing Address - Phone:561-627-3130
Mailing Address - Fax:561-627-8971
Practice Address - Street 1:500 UNIVERSITY BLVD.
Practice Address - Street 2:SUITE 208
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-627-3533
Practice Address - Fax:561-627-8971
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 0007129207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG27430Medicare UPIN
FL57327Medicare ID - Type Unspecified