Provider Demographics
NPI:1508036807
Name:OKPALEKE, CELINA
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:
Last Name:OKPALEKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 N HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-1614
Mailing Address - Country:US
Mailing Address - Phone:813-505-1922
Mailing Address - Fax:813-849-0922
Practice Address - Street 1:3202 N HOWARD AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1614
Practice Address - Country:US
Practice Address - Phone:813-505-1922
Practice Address - Fax:813-849-0922
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA3259363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical