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General NPI Number Information
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NPI Number | 1083551741
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Entity Type | Organization
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Legal Business Name | TREASURE COAST NON-SURGICAL ORTHOPEDICS PLLC
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 800 VIRGINIA AVE STE 45
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City | FORT PIERCE
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State | FL
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Zip | 34982-5893
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Country | US
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Telephone | 772-266-7846
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Fax | 561-510-9738
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Provider Business Mailing Address
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Address Line | 10380 SW VILLAGE CENTER DR STE 148
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City | PORT ST LUCIE
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State | FL
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Zip | 34987-1931
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Country | US
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Telephone | 772-266-7846
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Fax | 561-510-9738
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Authorized Official
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Title or Position | PHYSICIAN OWNER AND CEO
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Name | DR. OLUDARE OGUNSOLA
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Credential | DO
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Telephone | 772-266-7846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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