ADEWALE A. FAWOLE (NPI# 1073742359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073742359 |
| Entity Type | Individual |
| Full Name | ADEWALE A. FAWOLE |
| Credential | M.D. |
| Practice Address |
1400 N Us Highway 441 Ste 540 Lady Lake FL 32159-8987 |
| Mailing Address |
4371 Veronica S Shoemaker Blvd Fort Myers FL 33916-2216 |
| Practice Telephone | 3525613290 |
| Practice Fax Number | 3525613291 |
| Mailing Telephone | 2392748200 |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2020-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | ME134275 | FL | Allopathic & Osteopathic Physicians |
| N | 207RH0000X |
Internal Medicine Specialization: Hematology |
ME134275 | FL | Allopathic & Osteopathic Physicians |
| Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
ME134275 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 023178100 | 05 |
| Street Address |
1400 N US HIGHWAY 441 STE 540 |
| City | LADY LAKE |
| State | FL |
| Zip Code | 32159-8987 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548222490 | Irfan Ahmed | Internal Medicine | 1400 N Us Highway 441 Ste 540, Lady Lake, FL 32159-8987 | 2006-04-05 |
| 1295349173 | Merlyn Varona | Nurse Practitioner | 1400 N Us Highway 441 Ste 540, Lady Lake, FL 32159-8987 | 2020-09-08 |
| 1477104750 | Osheka Hansel | Nurse Practitioner | 1400 N Us Highway 441 Ste 540, Lady Lake, FL 32159-8987 | 2019-09-26 |
| 1225687957 | Maya Imani Paris | Registered Nurse | 1400 N Us Highway 441 Ste 540, Lady Lake, FL 32159-8987 | 2019-09-05 |
| 1073025466 | Kelly M Tripp | Nurse Practitioner | 1400 N Us Highway 441 Ste 540, Lady Lake, FL 32159-8987 | 2017-10-25 |
| 1962944660 | Christina Dada | Nurse Practitioner | 1400 N Us Highway 441 Ste 540, Lady Lake, FL 32159-8987 | 2016-11-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306451216 | Lindsey Porubcan | Physician Assistant | 990 South Us Highway 441/27, Lady Lake, FL 32159 | 2020-09-09 |
| 1073134979 | Michael Robert Frates | Dietitian, Registered | 900 Cr 466, Lady Lake, FL 32159 | 2020-05-01 |
| 1346800364 | Barbara Conrad | Social Worker | 906 Orchid Street, Lady Lake, FL 32159 | 2019-06-20 |
| 1962977165 | Curelogics Wound Care and Hyperbaric LLC | Registered Nurse | 809 County Road 466, Unit C-201, Lady Lake, FL 32159 | 2018-10-04 |
| 1346736907 | Caroline Butler | Physician Assistant | 805 E. Cr 466, Lady Lake, FL 32159 | 2018-07-06 |
| 1033609607 | Cyrus Immanuel Macalisang Doroy | Physical Therapist | 6340 County Rd 466, Suite 733, Lady Lake, FL 32159 | 2018-05-18 |
| 1962999680 | Sharma Institute of Pain Medicine | Physical Medicine & Rehabilitation | 1501 Us Hwy 441, Villages, FL 32159 | 2018-04-18 |
| 1538683198 | Cathleen Laurel Civiello | Psychologist | 929 H. Hwy 441, Suite 404, Lady Lake, FL 32159 | 2017-07-26 |
| 1649709015 | Adria Young | Optometrist | 801 Cr 466, Suite 102 Sunset Plaza, Lady Lake, FL 32159 | 2017-06-08 |
| 1891222527 | Center for Hope and Healing, LLC | Social Worker | 804 Hwy 466, Lady Lake, FL 32159 | 2017-05-12 |
| Find all providers in zip 32159 | ||||
| Taxonomy Code | 207RX0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Medical Oncology |
| An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093948556 | Ocala Oncology Center Pl | Internal Medicine | 13940 Us Hwy 441 N., Suite 203, Lady Lake, FL 32159-8909 | 2009-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568079648 | The Oncology Institute Fl, LLC | Internal Medicine | 2105 W Watrous Ave, Tampa, FL 33606-3046 | 2020-09-23 |
| 1821626383 | Tampa General Medical Group Inc | Internal Medicine | 17416 Brookside Trace Ct, Tampa, FL 33647-3589 | 2020-03-31 |
| 1770143752 | Raul Vera-gimon | Internal Medicine | 10730 Nw 66th St Apt 312, Doral, FL 33178-3708 | 2019-06-20 |
| 1740748706 | 21st Century Oncology LLC | Internal Medicine | 3651 Fau Blvd Ste 100, Boca Raton, FL 33431-6489 | 2019-03-08 |
| 1699243501 | Jose Armando Villamil | Internal Medicine | 8356 Sw 40th St Ste J, Miami, FL 33155-3356 | 2018-11-08 |
| 1790287878 | South Florida Cancer Institute | Internal Medicine | 1005 Marina Mile Blvd, Fort Lauderdale, FL 33315-2433 | 2018-03-05 |
| 1912350596 | Gilberto Lopes | Internal Medicine | 8345 Nw 66th St # 9886, Miami, FL 33195-2696 | 2016-07-19 |
| 1013382399 | Neil Howard Love | Internal Medicine | 2 S Biscayne Blvd, Ste 3600, Miami, FL 33131-1806 | 2015-12-11 |
| 1790115681 | Calvin Collins Jr. | Internal Medicine | 4403 Vineland Rd, Suite B5, Orlando, FL 32811 | 2013-11-14 |
| 1275895047 | Ira D Stein | Internal Medicine | 19 Jewfish Ave, Key Largo, FL 33037-4711 | 2012-06-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.