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NPI Code Detail

MEDICARE: ADESOLA AWOMOLO MD

MEDICARE: ADESOLA AWOMOLO 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
1207RX0202XMedical Oncology Physician01083014AIN
2207RX0202XMedical Oncology Physician200101004NC
3207RH0003XHematology & Oncology Physician3392WV

General Provider Information

NPI Number : 1699778894
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADESOLA AWOMOLO MD
Provider Business Mailing Address
First Line : 3555 10TH CT
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-5013
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1000 36TH ST
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-4862
Country : US
Telephone Number : 772-567-4673
Fax Number : 772-400-6932
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 03/11/2026

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