Provider Demographics
NPI:1407443807
Name:OGUINE, SAMUEL CHIGOZIE
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:CHIGOZIE
Last Name:OGUINE
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 1:12515 SHIREBROOK CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-4504
Mailing Address - Country:US
Mailing Address - Phone:813-951-4462
Mailing Address - Fax:
Practice Address - Street 1:12515 SHIREBROOK CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-4504
Practice Address - Country:US
Practice Address - Phone:813-951-4462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH435501835P0018X
FLPS60426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist