MEDICARE: DR. ONYEKA NWOKOCHA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	ME136750	FL

General Provider Information

NPI Number	:	1134462484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ONYEKA NWOKOCHA M.D.

Provider Business Mailing Address
First Line	:	663 NE 191ST TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-3972
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9415 NE 6TH AVE
Second Line	:
City	:	MIAMI SHORES
State	:	FL
Zip	:	33138-2737
Country	:	US
Telephone Number	:	786-401-6455
Fax Number	:	786-401-6394

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2013
Last Update Date	:	09/16/2019

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