Provider Demographics
NPI:1538594387
Name:OGUNSOLA, TOLUWALASE OLUWAKEMI (CRNP)
Entity type:Individual
Prefix:MS
First Name:TOLUWALASE
Middle Name:OLUWAKEMI
Last Name:OGUNSOLA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 VILLAGE SQUARE XING STE 290
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4552
Mailing Address - Country:US
Mailing Address - Phone:239-232-1180
Mailing Address - Fax:
Practice Address - Street 1:1122 DRUID RD E
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-4100
Practice Address - Country:US
Practice Address - Phone:727-461-2282
Practice Address - Fax:727-443-6170
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily