Provider Demographics
NPI:1316518418
Name:TRIPLEAMEDICAL
Entity type:Organization
Organization Name:TRIPLEAMEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:UGOCHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:ADIGWEME
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:904-521-2099
Mailing Address - Street 1:125 E PINE ST APT 1912
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3092
Mailing Address - Country:US
Mailing Address - Phone:904-521-2099
Mailing Address - Fax:
Practice Address - Street 1:125 E PINE ST APT 1912
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-3092
Practice Address - Country:US
Practice Address - Phone:904-521-2099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPO4010OtherMEDICAL LICENSE
FLPO4010Medicaid