Provider Demographics
NPI:1619925716
Name:OQUENDO, ANA C (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:C
Last Name:OQUENDO
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 1:4156 5TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-6304
Mailing Address - Country:US
Mailing Address - Phone:727-327-2714
Mailing Address - Fax:727-683-9921
Practice Address - Street 1:4156 5TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-6304
Practice Address - Country:US
Practice Address - Phone:727-327-2714
Practice Address - Fax:727-683-9921
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0060595173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12945OtherBCBS ID NUMBER
FL0105515OtherUNITED HEALTHCARE ID
FL0433552OtherCIGNA ID NUMBER
FL12945OtherBCBS ID NUMBER
FLFO3618Medicare UPIN