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General NPI Number Information
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NPI Number | 1659682854
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Entity Type | Individual
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Provider Name | BAMIDELE AYOOLA OLATUNBOSUN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2010
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 4520 E BAY DR
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City | CLEARWATER
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State | FL
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Zip | 33764-5714
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Country | US
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Telephone | 727-615-3032
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Fax | 727-615-2195
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Provider Business Mailing Address
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Address Line | 102 WOODMONT BLVD STE 600
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City | NASHVILLE
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State | TN
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Zip | 37205-5250
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Country | US
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Telephone | 888-987-1151
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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 | A143986
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License Number State | CA
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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 | ME148937
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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 | 142113
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License Number State | AK
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