MEDICARE: DR. PAMELA LYNN OJHA MD

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	207R00000X	Internal Medicine Physician	ME83169	FL
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	ME83169	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00382940	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	05080	OTHER	FL	BCBS OF FLORIDA
3	05080	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1730137282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAMELA LYNN OJHA MD

Provider Business Mailing Address
First Line	:	634 LOGGERHEAD ISLAND DR
Second Line	:
City	:	SATELLITE BEACH
State	:	FL
Zip	:	32937-3849
Country	:	US
Telephone Number	:	321-506-3985
Fax Number	:

Provider Business Practice Location Address
First Line	:	1326 MALABAR RD SE STE 3
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-2502
Country	:	US
Telephone Number	:	321-409-6100
Fax Number	:	321-409-6100

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	09/05/2024

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