Individual provider Active NPI

Adeleke O Omisande

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1962181768
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11027473 Issued in FL
Practice address
9981 S Healthpark Dr
Fort Myers, FL 33908-3618
Phone
(239) 343-2052
Fax
(239) 343-5348
NPI assigned
Jul 18, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11027473 FL
Family Nurse Practitioner 363LF0000X APRN11027473 FL Primary

Addresses

Primary practice location

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-2052

Other practice location 1

8271 SW 8th St
North Lauderdale, FL 33068-2030
Phone (954) 826-0432

Other identifiers 1

IdentifierTypeStateIssuer
120603800MedicaidFL

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231218000244 FL Practitioner - Nurse Practitioner 8325497233 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

1120 Homestead Rd N
Lehigh Acres, FL 33936-6044
Phone (239) 303-5020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11027473FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc Nurse Practitioner CurrentSince Oct 1, 2024 Accepting new patients
MD Now Medical Centers Inc Current Accepting new patients
Lee Memorial Health System Nurse Practitioner Current Accepting new patients
Eastside Hospitalists Inc Nurse Practitioner CurrentSince Jun 1, 2025 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Feb 5, 2024 Accepting new patients
MD Now Medical Centers Inc CurrentSince Jul 15, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Feb 5, 2024 Accepting new patients

Locations

1838 Rye Rd
#107
Bradenton, FL 34212
Phone (941) 462-2004

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

1120 Homestead Rd N
Lehigh Acres, FL 33936
Phone (239) 303-5020

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1962181768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-2052",
            "fax_number": "239-343-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9981 S HEALTHPARK DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083618",
            "telephone_number": "239-343-2052",
            "fax_number": "239-343-5348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8271 SW 8th St",
            "address_purpose": "LOCATION",
            "city": "North Lauderdale",
            "state": "FL",
            "postal_code": "330682030",
            "country_code": "US",
            "telephone_number": "954-826-0432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMISANDE",
        "first_name": "ADELEKE",
        "middle_name": "O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-18",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11027473",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11027473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120603800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.