MEDICARE: DR. ABIODUN SOSAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	ME72533	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	42512	OTHER	FL	MEDICARE CORE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659367167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABIODUN SOSAN MD

Provider Business Mailing Address
First Line	:	10262 BUENA VENTURA DR
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33498-6766
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 E SAMPLE RD
Second Line	:	NORTH BROWARD ED
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-3502
Country	:	US
Telephone Number	:	954-786-6400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	02/15/2008

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Directions to “ DR. ABIODUN SOSAN MD” Practice Location

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