Healthcare Provider Details
I. General information
NPI: 1316888308
Provider Name (Legal Business Name): MEDYTOP HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1209 MOUNTAIN ROAD PL NE STE N
ALBUQUERQUE NM
87110-7825
US
IV. Provider business mailing address
1209 MOUNTAIN ROAD PL NE STE N
ALBUQUERQUE NM
87110-7825
US
V. Phone/Fax
- Phone: 469-237-4933
- Fax:
- Phone: 469-237-4933
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TOLULOPE
A
OLOJEDE
Title or Position: FNP
Credential: FNP
Phone: 469-237-4933