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General NPI Number Information
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NPI Number | 1255527719
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Entity Type | Organization
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Legal Business Name | EZE D. UCHE, M.D., PA
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 4646 VIA DEL MEDICO
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City | LEESBURG
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State | FL
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Zip | 34748-6995
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Country | US
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Telephone | 352-360-0058
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Fax | 352-360-0024
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Provider Business Mailing Address
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Address Line | 4646 VIA DEL MEDICO
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City | LEESBURG
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State | FL
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Zip | 34748-6995
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Country | US
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Telephone | 352-360-0058
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Fax | 352-360-0024
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. ROSE A SMITH
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Credential | CMM
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Telephone | 352-360-0058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0073420
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License Number State | FL
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