Individual provider Active NPI

Bamidele Ayoola Olatunbosun, M.D.

  • Family Medicine Physician
  • Temple Terrace, FL
National Provider Identifier
1659682854
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME148937 Issued in FL
Practice address
9740 N 56TH St Ste B
Temple Terrace, FL 33617-5500
Phone
(813) 200-7717
NPI assigned
Jun 23, 2010
Last updated
Apr 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME148937 FL Primary
Family Medicine Physician 207Q00000X 142113 AK
Family Medicine Physician 207Q00000X A143986 CA

Addresses

Primary practice location

9740 N 56TH St Ste B
Temple Terrace, FL 33617-5500

Mailing address

425 W Colonial Dr Ste 303
Orlando, FL 32804-6863
Phone (321) 635-2190

Other practice location 1

10320 N 56th St Ste 100
Temple Terrace, FL 33617-4057
Phone (813) 422-5144

Other practice location 2

4520 E Bay Dr
Clearwater, FL 33764-5714
Phone (727) 615-3032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210819000807 FL Practitioner - Family Practice 3971898420 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wake Forest University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Family Physicians LLCGroup PAC ID 0749226439, 86 clinicians

Practice addresses (Care Compare)

10320 N 56TH St
Suite 100
Temple Terrace, FL 33617-4057
Phone (813) 442-5144

9740 N 56TH St
Suite B
Temple Terrace, FL 33617-5500
Phone (813) 200-7717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
142113AKMDFamily Medicine Physician
A143986CAMDFamily Medicine Physician
ME148937FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Just Medical Care Family Medicine CurrentSince Aug 2, 2021 Accepting new patients
Archwell Health Medical of Florida, LLC CurrentSince Sep 22, 2025 Accepting new patients
Western Sierra Medical Clinic, Inc. Past Accepting new patients

Locations

4520 E Bay Dr
Clearwater, FL 33764
Phone (727) 405-7188

10320 N 56th St
Ste 100
Temple Terrace, FL 33617
Phone (813) 422-5144

543 Tamiami Trl S
Venice, FL 34285
Phone (941) 837-8002

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

Interoperability endpoints

  • Direct secure messaging: bamidele.olatunbosun.1@24477.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/24477/brand/1/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1659682854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W COLONIAL DR STE 303",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046863",
            "telephone_number": "321-635-2190",
            "fax_number": "689-304-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9740 N 56TH ST STE B",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336175500",
            "telephone_number": "813-200-7717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10320 N 56th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Temple Terrace",
            "state": "FL",
            "postal_code": "336174057",
            "country_code": "US",
            "telephone_number": "813-422-5144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4520 E Bay Dr",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337645714",
            "country_code": "US",
            "telephone_number": "727-615-3032",
            "fax_number": "727-615-2195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLATUNBOSUN",
        "first_name": "BAMIDELE",
        "middle_name": "AYOOLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-23",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME148937",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "142113",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A143986",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.