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General NPI Number Information
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NPI Number | 1740823350
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Entity Type | Individual
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Provider Name | OLUWATOBI AJIBOLA
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Gender | Male
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Dates
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Enumeration Date | 10/26/2019
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Last Update Date | 10/26/2019
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Provider Practice Location Address
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Address Line | 6670 MOBILE HWY
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City | PENSACOLA
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State | FL
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Zip | 32526-1265
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Country | US
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Telephone | 850-483-6175
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Fax |
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Provider Business Mailing Address
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Address Line | 1095 IRONFORGE RD
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City | CANTONMENT
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State | FL
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Zip | 32533-8930
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS44514
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License Number State | FL
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