Provider Demographics
NPI:1487338240
Name:ADOMAKO, GODFRED FREMPONG
Entity type:Individual
Prefix:
First Name:GODFRED
Middle Name:FREMPONG
Last Name:ADOMAKO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13574 BROOKWATER DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-1972
Mailing Address - Country:US
Mailing Address - Phone:614-309-8804
Mailing Address - Fax:
Practice Address - Street 1:13574 BROOKWATER DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-1972
Practice Address - Country:US
Practice Address - Phone:614-309-8804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health