Active NPI
Olusegun Ayuba, PHARMACIST
- Pharmacist
- Tampa, FL
National Provider Identifier
1366619124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS43519
- Practice address
- 2210 E Hillsborough Ave Ste 4
Tampa, FL 33610-4450 - Phone
- (813) 237-6900
- Fax
- (813) 237-8600
- NPI assigned
- May 12, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS43519 | FL | Primary |
Addresses
Primary practice location
2210 E Hillsborough Ave Ste 4
Tampa, FL 33610-4450
Mailing address
11217 Madison Park Dr
Tampa, FL 33625-3996
Phone (813) 205-5255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS43519 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Triple Resources,Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Tampa, FL
- NPI 1528381415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314662400000",
"number": "1366619124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11217 MADISON PARK DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336253996",
"telephone_number": "813-205-5255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2210 E HILLSBOROUGH AVE STE 4",
"city": "TAMPA",
"state": "FL",
"postal_code": "336104450",
"telephone_number": "813-237-6900",
"fax_number": "813-237-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AYUBA",
"first_name": "OLUSEGUN",
"name_prefix": "Mr.",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-12",
"last_updated": "2011-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS43519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.