Individual
DR. MARY MICHELLE BOGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
712 THE RIALTO, VENICE, FL 34285-3524
(941) 488-0222
(941) 480-1668
Mailing address
712 THE RIALTO, VENICE, FL 34285-3524
(941) 488-0222
(941) 480-1668
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO3104
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U1808A
RAILROAD MEDICARE
FL
Enumeration date
08/04/2006
Last updated
11/09/2007
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