Provider Demographics
NPI:1497729610
Name:ONYIA, WILFRED IKEMEFUNA (MD)
Entity Type:Individual
Prefix:
First Name:WILFRED
Middle Name:IKEMEFUNA
Last Name:ONYIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 N ORANGE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-7613
Mailing Address - Country:US
Mailing Address - Phone:407-896-9660
Mailing Address - Fax:407-896-9661
Practice Address - Street 1:3000 N ORANGE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-7613
Practice Address - Country:US
Practice Address - Phone:407-896-9660
Practice Address - Fax:407-896-9661
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 98834207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002259900Medicaid
DG5582Medicare PIN
FL002259900Medicaid