Healthcare Provider Details

I. General information

NPI: 1245158542
Provider Name (Legal Business Name): PATRIOTIC VIRTUAL TELEHEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 NW 25TH ST UNIT 602
MIAMI FL
33127-4594
US

IV. Provider business mailing address

176 NW 25TH ST UNIT 602
MIAMI FL
33127-4594
US

V. Phone/Fax

Practice location:
  • Phone: 786-767-6845
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. OLALESI OSUNSADE
Title or Position: RADIOLOGIST
Credential: MD
Phone: 202-412-8078