Bade Akintan, MD
Individual provider Active NPI Urology Physician · Winter Haven, FL
NPI 1831202167 · NPPES record last updated Jul 7, 2014
Key facts
- NPI
- 1831202167
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Urology Physician 208800000X
- License
- ME96398 (FL)
- Practice address
- 201 Magnolia Ave SW
Winter Haven, FL 33880 - Phone
- (863) 293-6375
- Fax
- (863) 293-8877
- NPI assigned
- Aug 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070213000423 | FL | Practitioner - Urology | 4981507506 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME96398 | FL | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Florida Cancer Institute PA | Current |
Accepting new patients | |
| Central Florida Cancer Institute PA | Current |
Accepting new patients | |
| Spine Tyme Chiropractic and Wellness | Past |
Accepting new patients | |
| Bond Urgent Care LLC | Past | Accepting new patients | |
| Central Florida Cancer Institute PA | Past | Accepting new patients |
Locations
40107 Highway 27
Davenport, FL 33837
Phone (863) 419-0692
1420 Celebration Blvd
Ste 308
Kissimmee, FL 34747
Phone (407) 566-9899
201 Magnolia Ave SW
Winter Haven, FL 33880
Phone (863) 229-7950
Interoperability endpoints
- bade.akintan.p1@direct.bondclinicpa.nextgenshare.com
- https://api.platform.athenahealth.com/20634/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | ME96398 | FL | Yes |
Addresses
Primary practice location
201 Magnolia Ave SW
Winter Haven, FL 33880
Mailing address
PO Box 90758
Lakeland, FL 33804-0758
Phone (407) 566-9899
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 276351600 | Medicaid | FL | |
| 2763516-00 | Medicaid | FL |
Other names
- Bademosi Akintan
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All providers in Winter Haven, FL · Urology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.