Healthcare Provider Details

I. General information

NPI: 1033527858
Provider Name (Legal Business Name): OSAZE UWADIA PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2014
Last Update Date: 04/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 CHILD ST
JACKSONVILLE FL
32214-5005
US

IV. Provider business mailing address

2080 CHILD ST
JACKSONVILLE FL
32214-5005
US

V. Phone/Fax

Practice location:
  • Phone: 904-542-1540
  • Fax: 904-542-8348
Mailing address:
  • Phone: 904-542-1540
  • Fax: 904-542-8348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0013004
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: