Individual
EMEKA JUDE OKOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4712
(904) 308-7372
(904) 308-2908
Mailing address
2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4712
(904) 308-7372
(904) 308-2908
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME120789
FL
207Q00000X
Family Medicine Physician
TRN 16686
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013228500
—
FL
Enumeration date
06/27/2011
Last updated
12/30/2014
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