Olufunmilola Abiodun Olubukola, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ACN1496 Issued in FL

Practice address

1502 Village Oak LN
Kissimmee, FL 34746-6558

Phone

(407) 627-0066

Fax

(407) 440-4054

NPI assigned

Oct 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Olufunmilola Abiodun Olubukola Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Idelis Fedeslinda Arias de la Torre

  • General Practice Physician
  • Seffner, FL
  • NPI 1639747595
  NPD (past)
• Orlando Family Physicians, LLC

  • General Practice Physician
  • Orlando, FL
  • NPI 1912579673
  NPD (past)

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1609538016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 TAVISTOCK LAKES BLVD STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277592",
            "telephone_number": "321-332-6947",
            "fax_number": "497-286-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 VILLAGE OAK LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347466558",
            "telephone_number": "407-627-0066",
            "fax_number": "407-440-4054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Highway 129 Km 1.0 Ave. San Luis",
            "address_purpose": "LOCATION",
            "city": "Arecibo",
            "state": "PR",
            "postal_code": "00613",
            "country_code": "US",
            "telephone_number": "787-650-7274",
            "fax_number": "787-650-7258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLUBUKOLA",
        "first_name": "OLUFUNMILOLA",
        "middle_name": "ABIODUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PR",
            "license": "TBAJLDM-15-940I",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLUFUNMILOLA",
            "last_name": "OLUBUKOLA",
            "middle_name": "ABIODUN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Francheska Olivieri
• Nelgy Olivo Gonzalez, NELGY OLIVO GONZALEZ
• Vanessa E Olmeda
• Hanna Karin Louise Olofsson, MD
• Olayinka Abimbola Olubowale-Oshodi, P.T
• Olympus Home Care Inc.
• Juan Javier Omana, M.D.
• Omar Ata, D.D.S., PA.
• Omega Alpha Nu Ministries
• Candice Omega

• General Practice Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.