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Chukwuka G Ayetin, D.O.

Family Medicine in Brooksville, FL. Individual provider (NPI-1).

NPI number1508354432
StatusActive
Last updated in NPPESMar 7, 2023

Details

NPI
1508354432
Entity type
Individual (NPI-1)
Name
Chukwuka G Ayetin
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
Apr 26, 2018
Certification date
Dec 21, 2021
Last updated
Mar 7, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineOS17378FLYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

605 Lamar Ave
Brooksville, FL 34601-3211

Phone 352-796-9990 · Fax 352-796-2226

Mailing address

5130 Sunforest Dr Ste 300
Tampa, FL 33634-6327

Phone 727-824-0780 · Fax 813-514-8891

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