Provider Demographics
NPI:1639947120
Name:ADESHINA, ADEBOLA JULIEANA (CFN)
Entity Type:Individual
Prefix:MS
First Name:ADEBOLA
Middle Name:JULIEANA
Last Name:ADESHINA
Suffix:
Gender:F
Credentials:CFN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19046 BRUCE B DOWNS BLVD # 201
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2434
Mailing Address - Country:US
Mailing Address - Phone:813-787-1280
Mailing Address - Fax:
Practice Address - Street 1:1324 CRIMSON CLOVER LN
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-6575
Practice Address - Country:US
Practice Address - Phone:813-787-1280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education