INNOCENT ODOCHA MD PA NPI 1780709998

NPI Information

NPI: 1780709998
Provider Name: INNOCENT ODOCHA MD PA
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
816 NW 13TH ST
GAINESVILLE, FL
ZIP 32601
Phone: (352) 371-3212
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INNOCENT ODOCHA MD PA is a primary care clinic center in Gainesville, FL. INNOCENT ODOCHA MD PA NPI is 1780709998. The provider is registered as an organization entity type.

The provider's business location address is:

816 NW 13TH ST
GAINESVILLE, FL
ZIP 32601-903
Phone: (352) 371-3212
Fax: (352) 371-3213

The provider's authorized official is Innocent Odocha .
The authorized official title is President and has the following contact phone number (352) 371-3212.

The enumeration date for this NPI number is 3/20/2007 and was last updated on 5/14/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	ME86683	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	57823	OTHER		BLUE CROSS BLUE SHIELD
2	57823C	MEDICARE ID-TYPE UNSPECIFIED
3	H78823	MEDICARE UPIN
4	P00179043	OTHER		RAILROAD MEDICARE
5	266453400	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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