Provider Demographics
NPI:1730171372
Name:VOGEL, ESTHER S (PA-C)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:S
Last Name:VOGEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ESTEE
Other - Middle Name:S
Other - Last Name:VOGEL-SPERBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8181 NW 154TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5861
Mailing Address - Country:US
Mailing Address - Phone:305-558-3724
Mailing Address - Fax:
Practice Address - Street 1:21150 BISCAYNE BLVD.
Practice Address - Street 2:SUITE 102
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180
Practice Address - Country:US
Practice Address - Phone:305-935-6000
Practice Address - Fax:305-935-6248
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002306363A00000X
FLPA9105100363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000033976Medicaid
FLCW136ZMedicare PIN