Healthcare Provider Details

I. General information

NPI: 1619518198
Provider Name (Legal Business Name): CHINELO ONWUZOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2019
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N ARMENIA AVE STE 206
TAMPA FL
33604-1072
US

IV. Provider business mailing address

8900 N ARMENIA AVE STE 206
TAMPA FL
33604-1072
US

V. Phone/Fax

Practice location:
  • Phone: 813-261-1190
  • Fax: 813-261-1190
Mailing address:
  • Phone: 813-261-1190
  • Fax: 813-261-1190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberRN9321374
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: