Provider Demographics
NPI:1194822288
Name:ADEWUYI, FLORENCE ABOSEDE (DPT)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:ABOSEDE
Last Name:ADEWUYI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 MUSTANG RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4208
Mailing Address - Country:US
Mailing Address - Phone:972-384-0273
Mailing Address - Fax:972-384-0273
Practice Address - Street 1:632 MUSTANG RIDGE DR
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4208
Practice Address - Country:US
Practice Address - Phone:972-384-0273
Practice Address - Fax:972-384-0273
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1098069225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX612179Medicare ID - Type UnspecifiedINDIVIDUAL
TX612179Medicare ID - Type UnspecifiedGROUP