Provider Demographics
NPI:1255214763
Name:MUCHIRI, PETER M
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:M
Last Name:MUCHIRI
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 1:5116 GATE PKWY APT 4202
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0264
Mailing Address - Country:US
Mailing Address - Phone:786-856-8015
Mailing Address - Fax:
Practice Address - Street 1:5116 GATE PKWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-0260
Practice Address - Country:US
Practice Address - Phone:786-856-8015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9419113163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice