Healthcare Provider Details

I. General information

NPI: 1407380892
Provider Name (Legal Business Name): ANAYO LINDA OHADUGHA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 01/16/2021
Certification Date: 01/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1009 NW 5TH AVE
MIAMI FL
33136-3212
US

IV. Provider business mailing address

1756 N BAYSHORE DR APT 18L
MIAMI FL
33132-1147
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-2951
  • Fax:
Mailing address:
  • Phone: 910-574-0402
  • Fax: 870-451-0460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number228135
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME145439
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: