NPIMap

Organization Active NPI

Infectious Diseases of Mid-Florida, PA

  • Infectious Disease Physician
  • Ormond Beach, FL
National Provider Identifier
1396837308
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME86706 Issued in FL
Legal business name
INFECTIOUS DISEASES OF MID-FLORIDA, PA
Practice address
290 Clyde Morris Blvd Ste D2
Ormond Beach, FL 32174-8204
Phone
(386) 265-1021
Fax
(386) 265-1033
NPI assigned
Sep 28, 2006
Last updated
Sep 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ukonu Okoro Ejie, M.D.NPI 1790761500
Title
Provider
Phone
(386) 265-1021

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME86706 FL
Infectious Disease Physician 207RI0200X ME86706 FL Primary

Addresses

Primary practice location

290 Clyde Morris Blvd Ste D2
Ormond Beach, FL 32174-8204

Mailing address

PO Box 730606
Ormond Beach, FL 32173-0606
Phone (386) 265-1021

Other identifiers 2

IdentifierTypeStateIssuer
78720OtherFLBC OF FL
131432800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060206000052 FL Part B Supplier - Clinic/Group Practice 9032123526 Receives reassigned benefits from 7 practitioners
Practice locations: Ormond Beach, FL

National Provider Directory

National Provider Directory

Locations

104 Lacosta Ln
Ste 120
Daytona Beach, FL 32114
Phone (386) 274-0341

290 Clyde Morris Blvd
Ste D2
Ormond Beach, FL 32174
Phone (386) 265-1021

53 N Old Kings Rd
Ste E
Ormond Beach, FL 32174
Phone (386) 673-6004

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790121600000",
    "number": "1396837308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730606",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321730606",
            "telephone_number": "386-265-1021",
            "fax_number": "386-265-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 CLYDE MORRIS BLVD STE D2",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748204",
            "telephone_number": "386-265-1021",
            "fax_number": "386-265-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASES OF MID-FLORIDA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A",
        "authorized_official_last_name": "EJIE",
        "authorized_official_first_name": "UKONU",
        "authorized_official_middle_name": "OKORO",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "386-265-1021",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME86706",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME86706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC OF FL",
            "identifier": "78720",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131432800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.