Individual
MR. JIDEOFOR EBONY OBODOZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 MEMORIAL MEDICAL PKWY, DAYTONA BEACH, FL 32117-5167
(386) 231-6000
Mailing address
901 STERTHAUS DR, ORMOND BEACH, FL 32174-5133
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2021048898
MO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
ME165936
FL
Other
Enumeration date
05/04/2018
Last updated
06/09/2024
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