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Organization

EZE D. UCHE, M.D., PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ROSE A SMITH CMM (ADMINISTRATOR)
(352) 360-0058
Entity
Organization

Contact information

Practice address
4646 VIA DEL MEDICO, LEESBURG, FL 34748-6995
(352) 360-0058
(352) 360-0024
Mailing address
4646 VIA DEL MEDICO, LEESBURG, FL 34748-6995
(352) 360-0058
(352) 360-0024

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0073420
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060048208
RAILROAD MEDICARE
FL
05
252133400
FL
Enumeration date
09/19/2007
Last updated
08/06/2009
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