Provider Demographics
NPI:1144086497
Name:CHUDE, UCHENNA MAURICE
Entity type:Individual
Prefix:
First Name:UCHENNA
Middle Name:MAURICE
Last Name:CHUDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7532 AZALEA COVE CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-6225
Mailing Address - Country:US
Mailing Address - Phone:407-453-1216
Mailing Address - Fax:305-306-2184
Practice Address - Street 1:7532 AZALEA COVE CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-6225
Practice Address - Country:US
Practice Address - Phone:407-453-1216
Practice Address - Fax:305-306-2184
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11031450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily