Individual provider Active NPI

Azeezat Fashola, NP

  • Family Nurse Practitioner
  • Lutz, FL
National Provider Identifier
1962982207
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9330713 Issued in FL
Practice address
18956 N Dale Mabry Hwy Ste 102
Lutz, FL 33548-4915
Phone
(813) 948-8597
NPI assigned
Aug 16, 2018
Last updated
May 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9330713 FL Primary

Addresses

Primary practice location

18956 N Dale Mabry Hwy Ste 102
Lutz, FL 33548-4915

Mailing address

18956 N Dale Mabry Hwy
Ste 102
Lutz, FL 33548-4915
Phone (813) 948-8597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, WV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181220000258 FL Practitioner - Nurse Practitioner 1052656089
I20251229003873 WV Practitioner - Nurse Practitioner 1052656089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4055 Valley View LN
Dallas, TX 75244-5074

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9330713FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
GMS Florida West Coast Inc PastSince Apr 9, 2011 Accepting new patients
Ante Rudez MD PA Past Accepting new patients

Organizations & group practices 3

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": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1962982207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18956 N DALE MABRY HWY",
            "address_2": "STE 102",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484915",
            "telephone_number": "813-948-8597",
            "fax_number": "813-949-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18956 N DALE MABRY HWY STE 102",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484915",
            "telephone_number": "813-948-8597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASHOLA",
        "first_name": "AZEEZAT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9330713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.