David Omobasuyi LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2870242 Issued in FL

Legal business name

DAVID OMOBASUYI LLC

Practice address

9701 W Oakland Park Blvd
Sunrise, FL 33351-7015

Phone

(954) 572-4444

NPI assigned

Jun 13, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David Omobasuyi, ARNP, PMHNP-BC, DHSC

Title

President

Phone

(305) 898-7006

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528848000000",
    "number": "1255824355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15716 SW 26TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274271",
            "telephone_number": "305-898-7006",
            "fax_number": "305-898-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 W OAKLAND PARK BLVD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333517015",
            "telephone_number": "954-572-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID OMOBASUYI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A",
        "authorized_official_last_name": "OMOBASUYI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-898-7006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ARNP, PMHNP-BC, DHSC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "2870242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.