Provider Demographics
NPI:1851824783
Name:ADEWUYI, JOEL OLUSAYO (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:OLUSAYO
Last Name:ADEWUYI
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 1:1431 SW 1ST AVE
Mailing Address - Street 2:BITZER BLDG, SUITE 7 - GME
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-6500
Mailing Address - Country:US
Mailing Address - Phone:352-401-8311
Mailing Address - Fax:
Practice Address - Street 1:2980 SE 3RD CT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0445
Practice Address - Country:US
Practice Address - Phone:352-622-4231
Practice Address - Fax:352-622-0518
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-07
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME154767207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program