1053744771 NPI number — DR. MARGARET EKENE MGBEMENA MD

Table of content: DR. MARGARET EKENE MGBEMENA MD (NPI 1053744771)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053744771 NPI number — DR. MARGARET EKENE MGBEMENA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MGBEMENA
Provider First Name:
MARGARET
Provider Middle Name:
EKENE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NJOKU
Provider Other First Name:
MARGARET
Provider Other Middle Name:
EKENE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1053744771
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/01/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2871 SW BRIGHTON WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM CITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34990-6077
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-677-0413
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 S 23RD ST
Provider Second Line Business Practice Location Address:
LAWNWOOD REGIONAL MEDICAL CENTER& HEART INSTITUTE
Provider Business Practice Location Address City Name:
FORTE PIERCE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
772-461-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  ME127741 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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