Healthcare Provider Details

I. General information

NPI: 1942262647
Provider Name (Legal Business Name): VICTOR C NWAKAKWA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 UNDERWOOD ST
ORLANDO FL
32806-1110
US

IV. Provider business mailing address

22 UNDERWOOD ST
ORLANDO FL
32806-1110
US

V. Phone/Fax

Practice location:
  • Phone: 863-226-6011
  • Fax: 863-226-6031
Mailing address:
  • Phone: 863-226-6011
  • Fax: 863-226-6031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME85850
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: