Healthcare Provider Details

I. General information

NPI: 1609001254
Provider Name (Legal Business Name): VALENTINE CHIKE OKONKWO PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2009
Last Update Date: 05/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 S AVALON PARK BLVD SUITE 300
ORLANDO FL
32828-6997
US

IV. Provider business mailing address

457 S AVALON PARK BLVD SUITE 300
ORLANDO FL
32828-6997
US

V. Phone/Fax

Practice location:
  • Phone: 407-340-1182
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH24071
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: