Provider Demographics
NPI:1982232898
Name:AJUFO, CHUKWUEMEKA CHINEDU (MD)
Entity Type:Individual
Prefix:
First Name:CHUKWUEMEKA
Middle Name:CHINEDU
Last Name:AJUFO
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 1:7031 SW 62ND AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4701
Mailing Address - Country:US
Mailing Address - Phone:305-284-7500
Mailing Address - Fax:
Practice Address - Street 1:6850 LAKE NONA BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7408
Practice Address - Country:US
Practice Address - Phone:352-401-8312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-28
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME160364208D00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty