Provider Demographics
NPI:1841821451
Name:ONYEKWULUJE, NGOZI
Entity type:Individual
Prefix:
First Name:NGOZI
Middle Name:
Last Name:ONYEKWULUJE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550969 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:FL
Mailing Address - Zip Code:32046-8296
Mailing Address - Country:US
Mailing Address - Phone:678-665-5369
Mailing Address - Fax:
Practice Address - Street 1:150 BEDSTONE DR
Practice Address - Street 2:
Practice Address - City:ST JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-8211
Practice Address - Country:US
Practice Address - Phone:678-665-5369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-01
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58792183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist