MEDICARE: DR. UGOMMA AMY NWAHIRI PHARMD

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	183500000X	Pharmacist	PS46706	FL

General Provider Information

NPI Number	:	1588901227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. UGOMMA AMY NWAHIRI PHARMD

Provider Business Mailing Address
First Line	:	400 E CENTRAL BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-1923
Country	:	US
Telephone Number	:	407-872-7207
Fax Number	:	407-872-7213

Provider Business Practice Location Address
First Line	:	400 E CENTRAL BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-1923
Country	:	US
Telephone Number	:	407-872-7207
Fax Number	:	407-872-7213

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

Provider Enumeration Date	:	01/15/2013
Last Update Date	:	01/15/2013

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