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NPI Code Detail

MEDICARE: OLAKUNLE AJIBOLA M.D.

MEDICARE: OLAKUNLE AJIBOLA 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
1207Q00000XFamily Medicine PhysicianME112602FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1202I085802OTHERGAMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992851224
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLAKUNLE AJIBOLA M.D.
Provider Business Mailing Address
First Line : 14690 SPRING HILL DR STE 305
Second Line :
City : SPRING HILL
State : FL
Zip : 34609-8102
Country : US
Telephone Number : 352-277-5348
Fax Number : 352-606-2857
Provider Business Practice Location Address
First Line : 13235 STATE ROAD 52 STE 102
Second Line :
City : HUDSON
State : FL
Zip : 34669-2968
Country : US
Telephone Number : 727-378-8503
Fax Number : 727-857-7807
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2007
Last Update Date : 06/05/2025

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Directions to “ OLAKUNLE AJIBOLA M.D.” Practice Location

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