Basic Information
Provider Information
NPI: 1578889721
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AKINTOYE
FirstName: OLOLADE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1222 S ORANGE AVE
Address2:  
City: ORLANDO
State: FL
PostalCode: 328061215
CountryCode: US
TelephoneNumber: 4076496907
FaxNumber: 4074812035
Practice Location
Address1: 1222 S ORANGE AVE
Address2:  
City: ORLANDO
State: FL
PostalCode: 328061215
CountryCode: US
TelephoneNumber: 4076496907
FaxNumber: 4074812035
Other Information
ProviderEnumerationDate: 04/13/2010
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X75726GAN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0202XME132160FLY Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology

ID Information
IDTypeStateIssuerDescription
02081170005FL MEDICAID


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