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General NPI Number Information
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NPI Number | 1215406657
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Entity Type | Individual
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Provider Name | OLAGOKE KOLAPO APRN
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Gender | Male
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 5707 N 22ND ST
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City | TAMPA
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State | FL
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Zip | 33610-4350
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Country | US
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Telephone | 813-239-8069
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Fax | 813-231-7324
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Provider Business Mailing Address
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Address Line | 5707 N 22ND ST
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City | TAMPA
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State | FL
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Zip | 33610-4350
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Country | US
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Telephone | 813-239-8069
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Fax | 813-231-7324
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0812X
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Taxonomy Name | Community Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 11000701
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11000701
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN9340756
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License Number State | FL
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