Provider Demographics
NPI:1114229051
Name:UDO, INEMESIT (DNP,FNP-BC, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:INEMESIT
Middle Name:
Last Name:UDO
Suffix:
Gender:
Credentials:DNP,FNP-BC, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11830 PHILOSOPHY WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5098
Mailing Address - Country:US
Mailing Address - Phone:915-383-1640
Mailing Address - Fax:
Practice Address - Street 1:11830 PHILOSOPHY WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-5098
Practice Address - Country:US
Practice Address - Phone:915-383-1640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11024533363LF0000X, 363LP0808X
TXAP119547363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM476930ZS5HOtherWELLMED PTAN
NM49189Medicaid
NM300521013Medicare UPIN
NM49189Medicaid