Provider Demographics
NPI:1770195919
Name:IJAOPO, EZEKIEL OLUWASAYO (MD)
Entity Type:Individual
Prefix:DR
First Name:EZEKIEL
Middle Name:OLUWASAYO
Last Name:IJAOPO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2782 SW 33RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2831
Mailing Address - Country:US
Mailing Address - Phone:786-674-2833
Mailing Address - Fax:
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-575-7231
Practice Address - Fax:305-575-3365
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL157908207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine