Provider Demographics
NPI:1033599964
Name:UKEAGU, UCHE
Entity Type:Individual
Prefix:
First Name:UCHE
Middle Name:
Last Name:UKEAGU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 NW 86TH AVE APT 501
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1244
Mailing Address - Country:US
Mailing Address - Phone:954-415-5931
Mailing Address - Fax:
Practice Address - Street 1:100 E SYBELIA AVE STE 217
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4757
Practice Address - Country:US
Practice Address - Phone:954-415-5931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 11550111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor