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Individual

KOSISOCHUKWU NKENNA ANAGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
205 NE 2ND ST, OKEECHOBEE, FL 34972-2974
(561) 985-0433
(888) 508-5497
Mailing address
11924 FOREST HILL BLVD # 10A-243, WELLINGTON, FL 33414-6256
(561) 693-5143
(888) 726-9052

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME137136
FL
208M00000X
Hospitalist Physician
Primary
ME137136
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101899600
FL
01
14290897
CAQH
FL
01
AHYOI
FLORIDA BLUE
FL
Enumeration date
03/31/2015
Last updated
11/08/2022
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