Provider Demographics
NPI:1740877125
Name:ONYEWUMBU, SAMUEL (LMCH, MCAP , DR)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:ONYEWUMBU
Suffix:
Gender:M
Credentials:LMCH, MCAP , DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 CITRUS PARK LN
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-1855
Mailing Address - Country:US
Mailing Address - Phone:561-574-7900
Mailing Address - Fax:
Practice Address - Street 1:85 CITRUS PARK LN
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-1855
Practice Address - Country:US
Practice Address - Phone:561-574-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health