Individual
OBUNADIKE MBANUGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10855 SW 112TH AVE APT 118, MIAMI, FL 33176-3292
(305) 905-0233
Mailing address
10855 SW 112TH AVE APT 118, MIAMI, FL 33176-3292
(305) 905-0233
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11000693
FL
Other
Enumeration date
01/01/2019
Last updated
01/01/2019
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