Individual
MR. GODSON IFEANYI OGUCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
955 TOWN CENTER DR, SUITE 100, ORANGE CITY, FL 32763-8255
(386) 228-0661
(386) 228-0662
Mailing address
PO BOX 471027, LAKE MONROE, FL 32747-1027
(386) 228-0661
(386) 228-0662
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME89341
FL
207RI0200X
Infectious Disease Physician
Primary
ME89341
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17918
FL MEMORIAL HEALTH NETWOR
FL
01
—
264127
HEALTHEASE
FL
05
—
269494800
—
FL
01
—
46111
BC/BS
FL
01
—
P00145723
RR MEDICARE
FL
Enumeration date
01/25/2006
Last updated
01/28/2021
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