Individual
CARMELITA CHINYERE EBURUCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
918 ROLLING ACRES RD, SUITE #8, LADY LAKE, FL 32159-5027
(352) 750-6358
(352) 750-6329
Mailing address
918 ROLLING ACRES RD, SUITE #8, LADY LAKE, FL 32159-5027
(352) 750-6358
(352) 750-6329
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
74835
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00415689
RAILROAD MEDICARE
FL
Enumeration date
08/21/2006
Last updated
09/23/2011
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