Provider Demographics
NPI:1437148822
Name:INGYINN, MA (MD)
Entity Type:Individual
Prefix:
First Name:MA
Middle Name:
Last Name:INGYINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11633 HAMPTON PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-2947
Mailing Address - Country:US
Mailing Address - Phone:904-565-9533
Mailing Address - Fax:904-565-9533
Practice Address - Street 1:653-1 W 8TH ST
Practice Address - Street 2:DEPARTMENT OF PEDIATRIC UNIVERSITY OF FLORIDA
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-244-3027
Practice Address - Fax:904-244-3028
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93937208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H47810Medicare UPIN
4059581Medicare ID - Type Unspecified
FLH47810Medicare UPIN
FL29344ZMedicare PIN