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NPI Code Detail

MEDICARE: PETROS OGBAMICHAEL

MEDICARE: PETROS OGBAMICHAEL
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
1390200000XStudent in an Organized Health Care Education/Training ProgramFL

General Provider Information

NPI Number : 1225904022
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETROS OGBAMICHAEL
Provider Business Mailing Address
First Line : PO BOX 830926
Second Line :
City : MIAMI
State : FL
Zip : 33283-0926
Country : US
Telephone Number : 786-554-4170
Fax Number :
Provider Business Practice Location Address
First Line : 3200 S UNIVERSITY DR
Second Line :
City : DAVIE
State : FL
Zip : 33328-2018
Country : US
Telephone Number : 786-554-4170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2025
Last Update Date : 01/28/2026

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Directions to “ PETROS OGBAMICHAEL ” Practice Location

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