MEDICARE: DR. OJI JOSEPH 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	207RC0000X	Cardiovascular Disease Physician	ME78466	FL

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

General Provider Information

NPI Number	:	1720080096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OJI JOSEPH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 919349
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32891
Country	:	US
Telephone Number	:	863-676-6296
Fax Number	:	863-676-6431

Provider Business Practice Location Address
First Line	:	1136 BRYN MAWR AVE
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33853
Country	:	US
Telephone Number	:	863-676-6296
Fax Number	:	863-676-6431

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	10/07/2011

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