Healthcare Provider Details
I. General information
NPI: 1699792408
Provider Name (Legal Business Name): SYLVESTER C AJUFO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/16/2006
Last Update Date: 11/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2131 SW 22ND PL SUITE 202
OCALA FL
34471-7766
US
IV. Provider business mailing address
2131 SW 22ND PL SUITE 202
OCALA FL
34471-7766
US
V. Phone/Fax
- Phone: 352-369-3700
- Fax: 352-369-3931
- Phone: 352-369-3700
- Fax: 352-369-3931
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ME73660 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ME77338 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: