Provider Demographics
NPI:1336358191
Name:MBIONWU, CHIMEZIRI OSCAR (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHIMEZIRI
Middle Name:OSCAR
Last Name:MBIONWU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2183 HEATHWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-4604
Mailing Address - Country:US
Mailing Address - Phone:407-273-4801
Mailing Address - Fax:407-291-1797
Practice Address - Street 1:6801-D W. COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818
Practice Address - Country:US
Practice Address - Phone:407-291-1236
Practice Address - Fax:407-291-1797
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS28855183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist