Provider Demographics
NPI:1659682854
Name:OLATUNBOSUN, BAMIDELE AYOOLA (MD)
Entity type:Individual
Prefix:DR
First Name:BAMIDELE
Middle Name:AYOOLA
Last Name:OLATUNBOSUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WOODMONT BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5250
Mailing Address - Country:US
Mailing Address - Phone:888-987-1151
Mailing Address - Fax:
Practice Address - Street 1:4520 E BAY DR
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-5714
Practice Address - Country:US
Practice Address - Phone:727-615-3032
Practice Address - Fax:727-615-2195
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA143986207Q00000X
FLME148937207Q00000X
AK142113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine