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Individual

DR. ABIMBOLA ODUSANYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
13001 SOUTHERN BLVD, LOXAHATCHEE, FL 33470-9203
(561) 798-3300
Mailing address
11131 MANDERLY LN, WELLINGTON, FL 33467-7404

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME 82368
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06025
MEDICARE CORE
FL
Enumeration date
09/21/2005
Last updated
01/12/2024
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