Healthcare Provider Details

I. General information

NPI: 1053504589
Provider Name (Legal Business Name): FELIX CHUKWUEMEKA NWOKOLO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 DOUGLAS AVE STE 15
DUNEDIN FL
34698-7605
US

IV. Provider business mailing address

2874 ALLAPATTAH DR
CLEARWATER FL
33761-1801
US

V. Phone/Fax

Practice location:
  • Phone: 727-666-0222
  • Fax:
Mailing address:
  • Phone: 727-743-7539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME 99125
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number243784
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberME99125
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: