MEDICARE: AFOLASHADE AFOLAKE SHOYEBO FNP-BC

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
1	363LF0000X	Family Nurse Practitioner	F357823	NY
2	163W00000X	Registered Nurse	726041	NY

General Provider Information

NPI Number	:	1225574882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AFOLASHADE AFOLAKE SHOYEBO FNP-BC

Provider Business Mailing Address
First Line	:	11235 168TH ST
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11433-3917
Country	:	US
Telephone Number	:	347-249-3342
Fax Number	:

Provider Business Practice Location Address
First Line	:	11235 168TH ST
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11433-3917
Country	:	US
Telephone Number	:	347-249-3342
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2017
Last Update Date	:	02/26/2026

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