Provider Demographics
NPI:1790192185
Name:ALADESAWE ENTERPRISES INC.
Entity Type:Organization
Organization Name:ALADESAWE ENTERPRISES INC.
Other - Org Name:LEADING EDGE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AKINWUMI
Authorized Official - Middle Name:GAMMAL
Authorized Official - Last Name:ALADESAWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-368-3387
Mailing Address - Street 1:4753 US HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4945
Mailing Address - Country:US
Mailing Address - Phone:727-807-9948
Mailing Address - Fax:727-807-9950
Practice Address - Street 1:4753 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4945
Practice Address - Country:US
Practice Address - Phone:727-807-9948
Practice Address - Fax:727-807-9950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1127662081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHE345AMedicare PIN