Provider Demographics
NPI:1952643330
Name:NWANYANWU, RITA NWAKAEGO (MD)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:NWAKAEGO
Last Name:NWANYANWU
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2100 ALOMA AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3301
Mailing Address - Country:US
Mailing Address - Phone:321-422-3660
Mailing Address - Fax:407-644-2981
Practice Address - Street 1:2100 ALOMA AVE STE 204
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3301
Practice Address - Country:US
Practice Address - Phone:321-422-3660
Practice Address - Fax:407-644-2981
Is Sole Proprietor?:No
Enumeration Date:2013-03-23
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME128133207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101567300Medicaid