Jeffrey Michael Hartog, JEFFREY HARTOG M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME64197 Issued in FL

Practice address

4355 Bear Gully Rd
Winter Park, FL 32792-9422

Phone

(407) 678-3116

Fax

(321) 282-0565

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386711166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4355 BEAR GULLY RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327929422",
            "telephone_number": "407-678-3116",
            "fax_number": "321-282-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 BEAR GULLY RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327929422",
            "telephone_number": "407-678-3116",
            "fax_number": "321-282-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTOG",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "JEFFREY HARTOG M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME64197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Harrison
• Candice Elizabeth Hart
• Cynthia A Hart, RBT
• Hilah Hart, RBT
• Rebecca Hartmann, BCABA
• Michelle Glowacki Hartog, ARNP
• Charla Harvey-Jackson, APRN
• Nelson Harvey Jr.
• Shamim A Hasan, PA-C
• Ali Imran Hashmi

• Plastic Surgery Physician in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.