MEDICARE: GABRIEL O. OLOGUN 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	2086X0206X	Surgical Oncology Physician	ME167837	FL

General Provider Information

NPI Number	:	1952720120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIEL O. OLOGUN MD

Provider Business Mailing Address
First Line	:	2900 CORPORATE WAY
Second Line	:	DOOR D
City	:	MIRAMAR
State	:	FL
Zip	:	33025-3925
Country	:	US
Telephone Number	:	954-276-5685
Fax Number	:	954-985-7074

Provider Business Practice Location Address
First Line	:	1150 N 35TH AVE STE 670
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-5435
Country	:	US
Telephone Number	:	954-265-9520
Fax Number	:	954-265-9545

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

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	01/27/2026

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