Provider Demographics
NPI:1275092488
Name:OKOUKONI, CATHERINE O (MD/PHD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:O
Last Name:OKOUKONI
Suffix:
Gender:F
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5077 NW 125TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3448
Mailing Address - Country:US
Mailing Address - Phone:954-918-8219
Mailing Address - Fax:
Practice Address - Street 1:5077 NW 125TH AVE
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3448
Practice Address - Country:US
Practice Address - Phone:954-918-8219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program