Organization
MIDLAND FLORIDA INFECTIOUS DISEASES SPECIALISTS PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GODSON I OGUCHI M.D. (OWNER)
(386) 228-0661
Entity
Organization
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
207RI0200X
Infectious Disease Physician
Primary
ME89341
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000414800
—
FL
Enumeration date
06/04/2008
Last updated
08/11/2010
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