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General NPI Number Information
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NPI Number | 1558500447
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Entity Type | Individual
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Provider Name | TOLULOPE MATHIAS OLASUNKANMI MD
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Gender | Male
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Dates
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Enumeration Date | 02/17/2009
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 160 NW 170TH ST
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33169-5521
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Country | US
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Telephone | 305-651-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 213 S JEFFERSON ST STE 1006
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City | ROANOKE
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State | VA
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Zip | 24011-1713
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Country | US
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Telephone | 540-224-5353
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101248471
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME130642
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 23703
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | ME130642
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD441043
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 23703
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License Number State | WV
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Taxonomy #7
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101248471
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License Number State | VA
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