Provider Demographics
NPI:1962379131
Name:AROGUNNDADE, ADETAYO
Entity type:Individual
Prefix:
First Name:ADETAYO
Middle Name:
Last Name:AROGUNNDADE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15506 GOLDEN BELL ST
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-8834
Mailing Address - Country:US
Mailing Address - Phone:321-512-5382
Mailing Address - Fax:
Practice Address - Street 1:15506 GOLDEN BELL ST
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-8834
Practice Address - Country:US
Practice Address - Phone:321-512-5382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)