Healthcare Provider Details

I. General information

NPI: 1649109554
Provider Name (Legal Business Name): ERUOJOTULE ANTHONY ONOKWU FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 HOOKS ST UNIT 11301
CLERMONT FL
34711-3572
US

IV. Provider business mailing address

1700 HOOKS ST UNIT 11301
CLERMONT FL
34711-3572
US

V. Phone/Fax

Practice location:
  • Phone: 281-661-9635
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11047596
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: