MEDICARE: DR. OLALEKAN PETER OLUFEMI M.D.

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	207R00000X	Internal Medicine Physician	ME90831	FL
2	207R00000X	Internal Medicine Physician	C1-0024932	DE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	50012	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851340517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OLALEKAN PETER OLUFEMI M.D.

Provider Business Mailing Address
First Line	:	1067 PASEO DEL RIO NE
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33702-1469
Country	:	US
Telephone Number	:	727-563-0882
Fax Number	:	727-577-8161

Provider Business Practice Location Address
First Line	:	1700 N MCMULLEN BOOTH RD
Second Line	:	SUITE D-1
City	:	CLEARWATER
State	:	FL
Zip	:	33759-2130
Country	:	US
Telephone Number	:	727-669-3800
Fax Number	:	727-669-5600

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

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	05/23/2022

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Directions to “ DR. OLALEKAN PETER OLUFEMI M.D.” Practice Location

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