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NPI Code Detail

MEDICARE: TAJUDEEN OLAPOSI BASIRU MD

MEDICARE: TAJUDEEN OLAPOSI BASIRU MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianME171846FL
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1043951577
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAJUDEEN OLAPOSI BASIRU MD
Provider Business Mailing Address
First Line : 2909 ADDISON ST
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-6985
Country : US
Telephone Number : 979-422-7336
Fax Number :
Provider Business Practice Location Address
First Line : 10300 SW 216TH ST
Second Line :
City : CUTLER BAY
State : FL
Zip : 33190-1003
Country : US
Telephone Number : 305-252-5899
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2022
Last Update Date : 06/24/2026

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Directions to “ TAJUDEEN OLAPOSI BASIRU MD” Practice Location

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