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General NPI Number Information
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NPI Number | 1760093702
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA PRIMARY CARE PLLC
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Dates
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Enumeration Date | 08/13/2020
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 4243 SW CAMBRIDGE GLN
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City | LAKE CITY
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State | FL
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Zip | 32024-3431
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Country | US
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Telephone | 386-292-7744
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Fax | 386-719-7096
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Provider Business Mailing Address
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Address Line | 4243 SW CAMBRIDGE GLN
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City | LAKE CITY
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State | FL
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Zip | 32024-3431
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Country | US
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Telephone | 386-292-7744
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL C UKAEGBU SR.
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Credential | MD
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Telephone | 386-697-4973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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