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General NPI Number Information
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NPI Number | 1538594387
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Entity Type | Individual
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Provider Name | TOLUWALASE OLUWAKEMI OGUNSOLA CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2013
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 1122 DRUID RD E
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City | CLEARWATER
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State | FL
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Zip | 33756-4100
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Country | US
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Telephone | 727-461-2282
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Fax | 727-443-6170
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Provider Business Mailing Address
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Address Line | 900 VILLAGE SQUARE XING STE 290
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4552
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Country | US
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Telephone | 239-232-1180
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11016032
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License Number State | FL
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