Healthcare Provider Details
I. General information
NPI: 1952915563
Provider Name (Legal Business Name): NGOZI GLOBAL HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/01/2020
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2750 TAYLOR AVE STE A-59
ORLANDO FL
32806-4474
US
IV. Provider business mailing address
PO BOX 608296
ORLANDO FL
32860-8296
US
V. Phone/Fax
- Phone: 407-853-2611
- Fax:
- Phone: 407-853-2611
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
NGOZI
ODOH
Title or Position: DR. NGOZI ODOH, PHD, AGNP, APRN
Credential: PHD, MSN, AGNP, APRN
Phone: 407-853-2611