Organization Active NPI

Fogarty Chiropractic Life Clinic of Orlando, PA

  • Chiropractor
  • Orlando, FL
National Provider Identifier
1245371616
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FOGARTY CHIROPRACTIC LIFE CLINIC OF ORLANDO, PA
Practice address
12484 Lake Underhill Rd
Orlando, FL 32828-7100
Phone
(407) 281-0707
Fax
(407) 273-4793
NPI assigned
Feb 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert Fogarty, D.C.
Title
Director
Phone
(407) 281-0707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

12484 Lake Underhill Rd
Orlando, FL 32828-7100

Mailing address

12484 Lake Underhill Rd
Orlando, FL 32828-7100
Phone (407) 281-0707

Other identifiers 1

IdentifierTypeStateIssuer
381967100MedicaidFL

National Provider Directory

National Provider Directory

Locations

12484 Lake Underhill Rd
Orlando, FL 32828
Phone (407) 281-0707

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443744000000",
    "number": "1245371616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12484 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287100",
            "telephone_number": "407-281-0707",
            "fax_number": "407-273-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12484 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287100",
            "telephone_number": "407-281-0707",
            "fax_number": "407-273-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOGARTY CHIROPRACTIC LIFE CLINIC OF ORLANDO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2015-10-02",
        "status": "A",
        "authorized_official_last_name": "FOGARTY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "407-281-0707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381967100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.