Healthcare Provider Details

I. General information

NPI: 1457751067
Provider Name (Legal Business Name): JUDE NWABUGWU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2014
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 W OAKLAND PARK BLVD A-1
OAKLAND PARK FL
33311-1243
US

IV. Provider business mailing address

2901 W OAKLAND PARK BLVD A-1
OAKLAND PARK FL
33311-1243
US

V. Phone/Fax

Practice location:
  • Phone: 954-202-9334
  • Fax: 954-202-7912
Mailing address:
  • Phone: 954-202-9334
  • Fax: 954-202-7912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: