Healthcare Provider Details

I. General information

NPI: 1134048028
Provider Name (Legal Business Name): SEGUN FRANCIS OLORUNLOGBON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 SE ABSHIER BLD
BELLEVIEW FL
34420-3927
US

IV. Provider business mailing address

5800 SE ABSHIER BLD
BELLEVIEW FL
34420-3927
US

V. Phone/Fax

Practice location:
  • Phone: 352-245-2470
  • Fax: 352-245-9344
Mailing address:
  • Phone: 352-245-2470
  • Fax: 352-245-9344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS39599
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: