Provider Demographics
NPI:1164788618
Name:OBMANA, GINA FORONDA (MD)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:FORONDA
Last Name:OBMANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GINA
Other - Middle Name:OBMANA
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1171 CLIFF ROSE DR
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-2808
Mailing Address - Country:US
Mailing Address - Phone:407-770-1414
Mailing Address - Fax:407-447-8876
Practice Address - Street 1:1171 CLIFF ROSE DR
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-2808
Practice Address - Country:US
Practice Address - Phone:407-770-1414
Practice Address - Fax:407-447-8876
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 122206208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014427000Medicaid