Basic Information
Provider Information
NPI: 1124076377
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: UZOHO
FirstName: JONADAB
MiddleName: CHINEDU
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14690 SPRING HILL DR STE 101
Address2:  
City: SPRING HILL
State: FL
PostalCode: 346098102
CountryCode: US
TelephoneNumber: 3527990046
FaxNumber: 3526062857
Practice Location
Address1: 5350 SPRING HILL DR
Address2:  
City: SPRING HILL
State: FL
PostalCode: 346064562
CountryCode: US
TelephoneNumber: 3526888116
FaxNumber: 3526869477
Other Information
ProviderEnumerationDate: 05/04/2006
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XOS1002FLN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000X34008620OHN Allopathic & Osteopathic PhysiciansFamily Medicine 
208M00000XOS10002FLY Allopathic & Osteopathic PhysiciansHospitalist 

ID Information
IDTypeStateIssuerDescription
020690900005FL MEDICAID
00342550005FL MEDICAID
0869701 BCBSOTHER


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