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General NPI Number Information
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NPI Number | 1568378180
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Entity Type | Organization
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Legal Business Name | FKOG NP SERVICES
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Dates
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Enumeration Date | 08/22/2026
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Last Update Date | 08/22/2026
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Provider Practice Location Address
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Address Line | 5620 W WATERFORD DR
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City | DAVIE
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State | FL
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Zip | 33331-3215
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Country | US
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Telephone | 954-993-5595
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Fax |
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Provider Business Mailing Address
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Address Line | 5620 W WATERFORD DR
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City | DAVIE
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State | FL
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Zip | 33331-3215
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Country | US
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Telephone | 954-993-5595
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Fax |
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Authorized Official
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Title or Position | OWNER, PROVIDER
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Name | MS. FRIDAH K ORINA
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Credential | APRN-C
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Telephone | 954-993-5595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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