Provider Demographics
NPI:1972558146
Name:UCHE, EZE DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:EZE
Middle Name:DAVID
Last Name:UCHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CITRUS
Other - Middle Name:
Other - Last Name:CARDIOLOGY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:308 W HIGHLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-4716
Mailing Address - Country:US
Mailing Address - Phone:352-726-8353
Mailing Address - Fax:352-341-6885
Practice Address - Street 1:801 E DIXIE AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-7699
Practice Address - Country:US
Practice Address - Phone:352-315-0627
Practice Address - Fax:352-315-1012
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73420207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252133400Medicaid
K0208OtherGRP
FL252133400Medicaid
K0208OtherGRP