Oluwatoyin Adegoke, ARNP
Individual provider Active NPI Family Nurse Practitioner · Riverview, FL
NPI 1861858060 · NPPES record last updated Jul 13, 2021
Key facts
- NPI
- 1861858060
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- ARNP9274936 (FL)
- Practice address
- 12013 Running Fox Cir
Riverview, FL 33569-5686 - Phone
- (813) 220-1075
- NPI assigned
- Jan 5, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170908001939 | FL | Practitioner - Nurse Practitioner | 5890068019 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP9274936 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Department of Health | Current |
Accepting new patients | |
| Florida Department of Health | Current |
Accepting new patients |
Locations
1749 Holt Rd
Auburndale, FL 33823
Phone (863) 965-6259
1805 Hobbs Rd
Auburndale, FL 33823
Phone (863) 533-1111
1290 Golfview Ave
#4
Bartow, FL 33830
1290 Golfview Ave
Bartow, FL 33830
Phone (863) 519-7900
3241 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 413-2620
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | ARNP9274936 | FL | Yes |
Addresses
Primary practice location
12013 Running Fox Cir
Riverview, FL 33569-5686
Mailing address
12013 Running Fox Cir
Riverview, FL 33569-5686
Phone (813) 220-1075
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110769200 | Medicaid | FL |
Other providers in Riverview, FL
- Faithe A Adaire
- Breanna Adams
- Olive Adams
- Adaska Therapy and Wellness LLC
- Jesse Addis
- Fiona Naomi Adesoye
- Cheryl L Adkins
- Judi-Ann Adman
- Dana Marie Kimberly Adonis
- Advanced Dental Care of Riverview PLLC
All providers in Riverview, FL · Family Nurse Practitioner 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 13, 2021. 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.