Healthcare Provider Details

I. General information

NPI: 1598199192
Provider Name (Legal Business Name): DR. OSANEME CHUKA OKARO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2013
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5357 EHRLICH RD
TAMPA FL
33625-5505
US

IV. Provider business mailing address

5357 EHRLICH RD
TAMPA FL
33625-5505
US

V. Phone/Fax

Practice location:
  • Phone: 813-968-4003
  • Fax:
Mailing address:
  • Phone: 850-273-1344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS50719
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: