Healthcare Provider Details

I. General information

NPI: 1619134988
Provider Name (Legal Business Name): ADAOBI OKOBI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 11/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 COLUMBIA ST
ORLANDO FL
32806-1101
US

IV. Provider business mailing address

83 COLUMBIA ST
ORLANDO FL
32806-1101
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-2220
  • Fax: 321-843-2210
Mailing address:
  • Phone: 321-843-2220
  • Fax: 321-843-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number257836
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD439924
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME116808
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: