Individual
ADELEKE O OMISANDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9981 S HEALTHPARK DR, FORT MYERS, FL 33908-3618
(239) 343-2052
(239) 343-5348
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-2052
(239) 343-5348
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN11027473
FL
363LF0000X
Family Nurse Practitioner
Primary
APRN11027473
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120603800
—
FL
Enumeration date
07/18/2023
Last updated
05/14/2025
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