MEDICARE: DR. GILBERT OCHIENG MBEO 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
1	2084N0400X	Neurology Physician	18428	WI
2	2084N0400X	Neurology Physician	23790	MS
3	2084N0400X	Neurology Physician	0101271306	VA
4	2084N0400X	Neurology Physician	MT197627	PA
5	2084N0400X	Neurology Physician	83362	SC
6	2084N0400X	Neurology Physician	73752-20	WI
7	2084N0400X	Neurology Physician	2020-01021	NC
8	2084N0400X	Neurology Physician	04-42902	KS
9	2084N0400X	Neurology Physician	2020001525	MO
10	2084N0400X	Neurology Physician	65451	AZ
11	2084N0400X	Neurology Physician	ME142909	FL
12	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	ME142909	FL
13	208VP0014X	Interventional Pain Medicine Physician	ME142909	FL
14	2084A2900X	Neurocritical Care Physician	ME142909	FL
15	2084A2900X	Neurocritical Care Physician	83362	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396024949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GILBERT OCHIENG MBEO M.D.

Provider Business Mailing Address
First Line	:	13563 NARCOOSSEE RD FL 32832
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32832-7137
Country	:	US
Telephone Number	:	407-730-4240
Fax Number	:

Provider Business Practice Location Address
First Line	:	13563 NARCOOSSEE RD STE 110
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32832-7138
Country	:	US
Telephone Number	:	407-730-4240
Fax Number	:	407-887-1025

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2011
Last Update Date	:	07/13/2023

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