Provider Demographics
NPI:1679509830
Name:AKINYODE, AKINSOLA MIKAIL (BMR PT)
Entity Type:Individual
Prefix:MR
First Name:AKINSOLA
Middle Name:MIKAIL
Last Name:AKINYODE
Suffix:
Gender:M
Credentials:BMR PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2107 SE 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5118
Mailing Address - Country:US
Mailing Address - Phone:352-732-7269
Mailing Address - Fax:352-732-3867
Practice Address - Street 1:2107 SE 3RD AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5118
Practice Address - Country:US
Practice Address - Phone:352-732-7269
Practice Address - Fax:352-732-3867
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 10448225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY8325Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER