Provider Demographics
NPI:1598744674
Name:OIBO, JOSEPH A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:OIBO
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 1:1732 SW 1ST AVENUE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-1700
Mailing Address - Country:US
Mailing Address - Phone:352-622-4888
Mailing Address - Fax:352-694-4884
Practice Address - Street 1:1730 SW 1ST AVENUE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-1700
Practice Address - Country:US
Practice Address - Phone:352-622-4888
Practice Address - Fax:352-694-4884
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70676207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251392700Medicaid
FLG27408Medicare UPIN
FL251392700Medicaid