Individual
IDEMUDIA GEORGE IDEHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
975 BAPTIST WAY, HOMESTEAD, FL 33033-7600
(786) 243-8000
Mailing address
253 NE 2ND ST APT 2709, MIAMI, FL 33132-2299
(818) 859-6057
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME160227
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2020
Last updated
01/03/2024
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