Provider Demographics
NPI:1164059770
Name:UMEH, UWAEZU JOY (NP)
Entity Type:Individual
Prefix:
First Name:UWAEZU
Middle Name:JOY
Last Name:UMEH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13650 W COLONIAL DR STE 130C
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3993
Mailing Address - Country:US
Mailing Address - Phone:510-300-5613
Mailing Address - Fax:
Practice Address - Street 1:13650 W COLONIAL DR STE 130C
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3993
Practice Address - Country:US
Practice Address - Phone:510-300-5613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014246363LF0000X
FL11011377363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily