Individual ProviderOsayande OsagiedeInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4500 San Pablo Rd S, Jacksonville, FL 32224-1865(904) 953-2000PECOS EnrollmentBased on the most recent information from CMS, provider Osayande Osagiede is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1285195412Provider TypeIndividualFull NameOsagiede, OsayandeCredentialMD, MPHGenderMaleSole ProprietorNoEnumeration Date3/29/2019Last Updated6/17/2022Contact InformationPractice LocationPractice Address4500 San Pablo Rd S, Jacksonville, FL 32224-1865Phone(904) 953-2000FaxUnlisted FaxMailing LocationMailing Address4500 San Pablo Rd S, Jacksonville, FL 32224-1865Phone(904) 953-2000FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207RG0100XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseME154529Florida