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NPI Code Detail

MEDICARE: JUDY A OGNIBENE M.D.

MEDICARE: JUDY A OGNIBENE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician26674KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4260040225OTHERKYRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
353275OTHERFLBLUE CROSS BLUE SHIELD OF FLORIDA
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164459103
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDY A OGNIBENE M.D.
Provider Business Mailing Address
First Line : 2634 CAPITAL CIR NE BLDG C
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-4106
Country : US
Telephone Number : 850-523-3333
Fax Number : 850-523-3334
Provider Business Practice Location Address
First Line : 2634 CAPITAL CIR NE BLDG C
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-4106
Country : US
Telephone Number : 850-523-3289
Fax Number : 850-523-3334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2006
Last Update Date : 09/24/2020

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Directions to “ JUDY A OGNIBENE M.D.” Practice Location

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