Active NPI
Fogarty Chiropractic Life Clinic of Orlando, PA
- Chiropractor
- Orlando, FL
National Provider Identifier
1245371616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 381967100 | Medicaid | FL |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Chiropractor
- Orlando, FL
- NPI 1154792083
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.