# MICHAEL FOGT P A

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841409505
- **Authorized official:** MICHAEL L FOGT O D (OPTOMETRIST SOLE PROPRIETOR)
- **Authorized official phone:** (772) 287-2663

## Contact information

- **Practice address:** 900 SE OCEAN BLVD, STE. 106A, STUART, FL 34994-2471
- **Practice address phone:** (772) 287-2663
- **Practice address fax:** (772) 781-6797
- **Mailing address:** 900 SE OCEAN BLVD, STE. 106A, STUART, FL 34994-2471
- **Mailing address phone:** (772) 287-2663
- **Mailing address fax:** (772) 781-6797

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC980 | FL | Yes |

## Other

- **Enumeration date:** 05/21/2007
- **Last updated:** 03/07/2008