Individual
FOLAYAN FATADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 842-8475
Mailing address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 842-8475
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME126929
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022410700
—
FL
01
—
7DF2N
BCBS
—
01
—
O9540
MEDICARE PTAN OHRI
FL
01
—
PS573
MEDICARE PTAN OHMG
FL
Enumeration date
04/01/2008
Last updated
03/30/2023
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