Individual
PETER C IGWILO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3640 NW 8TH ST, FT LAUDERDALE, FL 33311-6418
(954) 618-7151
(954) 616-5698
Mailing address
3640 NW 8TH ST, FT LAUDERDALE, FL 33311-6418
(954) 618-7151
(954) 616-5698
Taxonomy
Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002757900
—
FL
Enumeration date
03/22/2011
Last updated
03/22/2011
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