Individual
DR. ADETOLA FADEYIBI LOUIS-JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3603
(352) 273-7584
Mailing address
PO BOX 100294, GAINESVILLE, FL 32610-0294
(352) 273-7584
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
ME132996
FL
207V00000X
Obstetrics & Gynecology Physician
MT198091
PA
207VM0101X
Maternal & Fetal Medicine Physician
Primary
ME132996
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021637700
—
FL
01
—
JTH59
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/09/2010
Last updated
07/12/2021
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