MEDICARE: DR. CHIAKA A OPARAOCHA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME114870	FL
2	390200000X	Student in an Organized Health Care Education/Training Program

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730409012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHIAKA A OPARAOCHA M.D.

Provider Business Mailing Address
First Line	:	1395 NW 167TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-5710
Country	:	US
Telephone Number	:	305-628-6117
Fax Number	:	305-393-5989

Provider Business Practice Location Address
First Line	:	4270 ALOMA AVE
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-9424
Country	:	US
Telephone Number	:	305-628-6117
Fax Number	:	305-393-5989

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2010
Last Update Date	:	11/15/2021

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