MEDICARE: GREGORY W OFORI RN

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	163WH0200X	Home Health Registered Nurse	RN9483014	FL

General Provider Information

NPI Number	:	1902498975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY W OFORI RN

Provider Business Mailing Address
First Line	:	151 GRAND JUNCTION BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-1254
Country	:	US
Telephone Number	:	321-440-9419
Fax Number	:

Provider Business Practice Location Address
First Line	:	151 GRAND JUNCTION BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-1254
Country	:	US
Telephone Number	:	321-440-9419
Fax Number	:

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

Provider Enumeration Date	:	02/10/2021
Last Update Date	:	02/10/2021

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