Provider Demographics
NPI:1003017435
Name:WEST ORANGE HEALTHCARE DISTRICT
Entity Type:Organization
Organization Name:WEST ORANGE HEALTHCARE DISTRICT
Other - Org Name:DIEGUEZ & OLOUFA OBGYN OF HEALTH CENTRAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:MIQUEL
Authorized Official - Last Name:DIEGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-578-0033
Mailing Address - Street 1:10000 W COLONIAL DR
Mailing Address - Street 2:STE 387
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3498
Mailing Address - Country:US
Mailing Address - Phone:407-578-0033
Mailing Address - Fax:407-294-8003
Practice Address - Street 1:10000 W COLONIAL DR
Practice Address - Street 2:STE 387
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3498
Practice Address - Country:US
Practice Address - Phone:407-578-0033
Practice Address - Fax:407-294-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069787700Medicaid
K3453AMedicare Oscar/Certification
FL069787700Medicaid