MEDICARE: JENNIFFER DE LA ROSA OGANDO 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	207R00000X	Internal Medicine Physician	ME134567	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	:	1891176038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFFER DE LA ROSA OGANDO M.D

Provider Business Mailing Address
First Line	:	5717 RED BUG LAKE RD STE 341
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-4957
Country	:	US
Telephone Number	:	321-207-0174
Fax Number	:	321-207-0175

Provider Business Practice Location Address
First Line	:	1800 N HANCOCK RD
Second Line	:
City	:	MINNEOLA
State	:	FL
Zip	:	34715-8184
Country	:	US
Telephone Number	:	689-289-2654
Fax Number	:	589-289-2655

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

Provider Enumeration Date	:	06/12/2015
Last Update Date	:	03/04/2026

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