Provider Demographics
NPI:1255663431
Name:AGBI, ANDREW OMOH (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:OMOH
Last Name:AGBI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:OMOH
Other - Middle Name:ANDREW
Other - Last Name:AGBI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:2542 COOPER WAY
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3412
Mailing Address - Country:US
Mailing Address - Phone:718-541-9611
Mailing Address - Fax:
Practice Address - Street 1:2542 COOPER WAY
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3412
Practice Address - Country:US
Practice Address - Phone:718-541-9611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10970207P00000X
FLOS0010970207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine