Provider Demographics
NPI:1487823720
Name:AJIBOYE, NORMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:
Last Name:AJIBOYE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:1150 N 35TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5428
Practice Address - Country:US
Practice Address - Phone:954-265-1490
Practice Address - Fax:954-265-9779
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC390200000207T00000X
TXR1484207T00000X
FLME1479982084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery