Provider Demographics
NPI:1649803883
Name:USIFIYOKHO MD INC
Entity type:Organization
Organization Name:USIFIYOKHO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMEON
Authorized Official - Middle Name:USIFO
Authorized Official - Last Name:OSEMOTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-740-3162
Mailing Address - Street 1:6471 SW 26TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-3809
Mailing Address - Country:US
Mailing Address - Phone:954-740-3162
Mailing Address - Fax:
Practice Address - Street 1:501 E LAS OLAS BLVD STE 300
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2882
Practice Address - Country:US
Practice Address - Phone:954-740-3162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care