Individual
DR. MICHAEL LEE FOGT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
900 SE OCEAN BLVD, SUITE 106A, STUART, FL 34994-2471
(772) 287-2663
(772) 781-6797
Mailing address
900 SE OCEAN BLVD, SUITE 106A, STUART, FL 34994-2471
(772) 287-2663
(772) 781-6797
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC980
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4875080001
DMERC
FL
Enumeration date
08/23/2005
Last updated
03/04/2009
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