Healthcare Provider Details

I. General information

NPI: 1396024949
Provider Name (Legal Business Name): GILBERT OCHIENG MBEO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2011
Last Update Date: 07/13/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13563 NARCOOSSEE RD STE 110
ORLANDO FL
32832-7138
US

IV. Provider business mailing address

13563 NARCOOSSEE RD FL 32832
ORLANDO FL
32832-7137
US

V. Phone/Fax

Practice location:
  • Phone: 407-730-4240
  • Fax: 407-887-1025
Mailing address:
  • Phone: 407-730-4240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number18428
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number23790
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0101271306
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMT197627
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number83362
License Number StateSC
# 6
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number73752-20
License Number StateWI
# 7
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2020-01021
License Number StateNC
# 8
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number04-42902
License Number StateKS
# 9
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2020001525
License Number StateMO
# 10
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number65451
License Number StateAZ
# 11
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME142909
License Number StateFL
# 12
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License NumberME142909
License Number StateFL
# 13
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME142909
License Number StateFL
# 14
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License NumberME142909
License Number StateFL
# 15
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number83362
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: