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NPI Code Detail

MEDICARE: DR. AJOKE BAMISILE M.D.

MEDICARE: DR. AJOKE BAMISILE M.D.
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
1207R00000XInternal Medicine PhysicianME119956FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215221528
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AJOKE BAMISILE M.D.
Provider Business Mailing Address
First Line : 3505 LAKE LYNDA DR STE 200
Second Line :
City : ORLANDO
State : FL
Zip : 32817-8333
Country : US
Telephone Number : 407-567-1907
Fax Number : 407-550-7469
Provider Business Practice Location Address
First Line : 3505 LAKE LYNDA DR STE 200
Second Line :
City : ORLANDO
State : FL
Zip : 32817-8333
Country : US
Telephone Number : 407-567-1907
Fax Number : 407-550-7469
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2011
Last Update Date : 04/07/2024

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