Healthcare Provider Details

I. General information

NPI: 1700526449
Provider Name (Legal Business Name): AHMED AYOBAMI SHOOLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

1020 CAVERN DR
MESQUITE TX
75181-4419
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-8017
  • Fax:
Mailing address:
  • Phone: 469-735-2970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: