Individual
DR. OLUDARE OGUNSOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
800 VIRGINIA AVE STE 45, FORT PIERCE, FL 34982-5893
(740) 779-4598
(740) 779-4599
Mailing address
10380 SW VILLAGE CENTER DR STE 148, PORT ST LUCIE, FL 34987-1931
(772) 266-7846
(561) 510-9738
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
34.012784
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0218810
—
OH
01
—
OS23382
MEDICAL LICENSE
FL
Enumeration date
08/12/2008
Last updated
05/06/2026
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