Provider Demographics
NPI:1760282933
Name:ADEGBORIOYE, ABIMBOLA (FNP-C)
Entity type:Individual
Prefix:
First Name:ABIMBOLA
Middle Name:
Last Name:ADEGBORIOYE
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 NW 103RD TER
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-6628
Mailing Address - Country:US
Mailing Address - Phone:954-918-9709
Mailing Address - Fax:
Practice Address - Street 1:1360 NW 103RD TER
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-6628
Practice Address - Country:US
Practice Address - Phone:954-918-9709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF03250475363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily