Provider Demographics
NPI:1841862216
Name:OFODILE, UCHENNA
Entity type:Individual
Prefix:
First Name:UCHENNA
Middle Name:
Last Name:OFODILE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:UCHENNA
Other - Middle Name:
Other - Last Name:OFODILE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:111 N ORANGE AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-2381
Mailing Address - Country:US
Mailing Address - Phone:407-556-9465
Mailing Address - Fax:407-839-6660
Practice Address - Street 1:111 N ORANGE AVE STE 800
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2381
Practice Address - Country:US
Practice Address - Phone:407-556-9465
Practice Address - Fax:407-839-6660
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-22-14073106E00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109512300Medicaid