| Ridgewood Physicians, Pllc | |
|
2725 Northampton Ave Orlando FL 32828-7910 | |
| (689) 253-2379 | |
| (731) 660-2121 |
| Full Name | Ridgewood Physicians, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2725 Northampton Ave, Orlando, Florida |
| Authorized Official Name and Position | Kamaldeen Agoro (OWNER) |
| Authorized Official Contact | 6892532379 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ridgewood Physicians, Pllc 2725 Northampton Ave Orlando FL 32828-7910 Ph: (689) 253-2379 | Ridgewood Physicians, Pllc 2725 Northampton Ave Orlando FL 32828-7910 Ph: (689) 253-2379 |
| NPI Number | 1053936344 |
|---|---|
| Provider Enumeration Date | 06/11/2020 |
| Last Update Date | 02/06/2024 |
| Medicare PECOS PAC ID | 9638593742 |
|---|---|
| Medicare Enrollment ID | O20200722002498 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053936344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kamaldeen Agoro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528325644 PECOS PAC ID: 2466760384 Enrollment ID: I20200624001031 |
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