| Doctor Name: | DR. OLUDARE OGUNSOLA |
| NPI Number: | 1598911323 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | OS11599 |
| Business Practice Address: | 2007 Palm Beach Lakes Blvd West Palm Beach, FL - 334096501 |
| Business Phone Number: | 5614208555 |
| Business Fax Number: | 5614208550 |
| Mailing Address: | 1429 Lakeland Hills Blvd, LAKELAND |
| State: | FL |
| Postal Code: | 338053206 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/12/2008 |
| NPI Last Update Date: | 02/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | OS11599 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |