Organization
UGA STREET, INC
Active
Parent organization
UGA STREET, INC
Other names
UGA STREET CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
UGA STREET, INC
Authorized official
CHRISTIAN NWOYE R.PH, (PRESIDENT/CEO)
(813) 248-1621
Entity
Organization
Contact information
Practice address
3302 E. MARTIN LUTHER KING JR BLVD. #101, TAMPA, FL 33610
(813) 248-1621
(813) 248-5408
Mailing address
PO BOX 310256, TAMPA, FL 33680-0256
(813) 248-1621
(813) 248-5408
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
HCC009401
FL
Other
Enumeration date
04/30/2012
Last updated
04/30/2012
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