Individual
IFEANYI EJIEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9712 S ORANGE AVE, ORLANDO, FL 32824-7211
(844) 395-4100
Mailing address
9712 S ORANGE AVE, ORLANDO, FL 32824-7211
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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