Provider Demographics
NPI:1396024949
Name:MBEO, GILBERT OCHIENG (MD)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:OCHIENG
Last Name:MBEO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13563 NARCOOSSEE RD FL 32832
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-7137
Mailing Address - Country:US
Mailing Address - Phone:407-730-4240
Mailing Address - Fax:
Practice Address - Street 1:13563 NARCOOSSEE RD STE 110
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-7138
Practice Address - Country:US
Practice Address - Phone:407-730-4240
Practice Address - Fax:407-887-1025
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI184282084N0400X
MS237902084N0400X
VA01012713062084N0400X
PAMT1976272084N0400X
SC833622084N0400X, 2084A2900X
WI73752-202084N0400X
NC2020-010212084N0400X
KS04-429022084N0400X
MO20200015252084N0400X
AZ654512084N0400X
FLME1429092084N0400X, 2084P2900X, 208VP0014X, 2084A2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09185861Medicaid
SC833628Medicaid