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Individual

DOMINICA NGOZI ORISAKWE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3390 TAMIAMI TRL STE 204, PORT CHARLOTTE, FL 33952-8162
(941) 391-5495
Mailing address
17400 TERRY AVE, PORT CHARLOTTE, FL 33948-1373
(941) 766-8638

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3209032
FL

Other

Enumeration date
06/15/2018
Last updated
06/15/2018
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