Healthcare Provider Details

I. General information

NPI: 1699685420
Provider Name (Legal Business Name): BINTA MARGARET AUDU ONYIBE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 SILVER BLUFF BLVD
ORANGE PARK FL
32065-4262
US

IV. Provider business mailing address

3750 SILVER BLUFF BLVD APT 2201
ORANGE PARK FL
32065-4268
US

V. Phone/Fax

Practice location:
  • Phone: 719-369-6388
  • Fax:
Mailing address:
  • Phone: 719-369-6388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: