Individual
CHUKWUEMEKE DIKE SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 CITRUS BLVD, LEESBURG, FL 34748-7204
(352) 326-4044
Mailing address
7170 SE 12TH CIR, OCALA, FL 34480-6650
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS36553
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS36553
STATE OF FLORIDA PHARMACY LICENSE
FL
Enumeration date
10/27/2020
Last updated
10/27/2020
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