Individual
DR. CANICE CHUKWUOCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
264A PALM COAST PKWY NE, PALM COAST, FL 32137-8217
(386) 446-5505
Mailing address
2460 OLD MOULTRIE RD STE 1, ST AUGUSTINE, FL 32086-4198
(904) 293-0299
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
021723
PR
208D00000X
General Practice Physician
Primary
ACN1489
FL
Other
Enumeration date
07/15/2020
Last updated
01/06/2023
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