Provider Demographics
NPI:1336137637
Name:OKEREKE, CHIKA (MD)
Entity Type:Individual
Prefix:
First Name:CHIKA
Middle Name:
Last Name:OKEREKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7824 LAKE UNDERHILL RD
Mailing Address - Street 2:STE. I
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8201
Mailing Address - Country:US
Mailing Address - Phone:407-380-3400
Mailing Address - Fax:407-380-6655
Practice Address - Street 1:7824 LAKE UNDERHILL RD
Practice Address - Street 2:STE. I
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8201
Practice Address - Country:US
Practice Address - Phone:407-380-3400
Practice Address - Fax:407-380-6655
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88072207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH92214Medicare UPIN
FL71866YMedicare PIN