Healthcare Provider Details

I. General information

NPI: 1003658907
Provider Name (Legal Business Name): CHRISTIAN A OKAFOR PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2024
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39200 HOOKER HWY
BELLE GLADE FL
33430-5368
US

IV. Provider business mailing address

10102 BRIGHTFIELD LN
UPPER MARLBORO MD
20772-2411
US

V. Phone/Fax

Practice location:
  • Phone: 301-357-4051
  • Fax:
Mailing address:
  • Phone: 301-357-4051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: