Healthcare Provider Details

I. General information

NPI: 1104534247
Provider Name (Legal Business Name): SKYHIGH CHILDREN HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2022
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 SE 1ST AVE STE 102
OCALA FL
34471-0478
US

IV. Provider business mailing address

1202 SW 17TH ST STE 201
OCALA FL
34471-1283
US

V. Phone/Fax

Practice location:
  • Phone: 352-505-1301
  • Fax: 352-505-9846
Mailing address:
  • Phone: 352-505-1301
  • Fax: 352-505-9846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BOLANLE ADEBIYI
Title or Position: OWNER/DIRECTOR
Credential: MD
Phone: 352-505-1301