Provider Demographics
NPI:1972180925
Name:SANNI, HABEEB OLAWALE (MD)
Entity Type:Individual
Prefix:DR
First Name:HABEEB
Middle Name:OLAWALE
Last Name:SANNI
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 1:7393 BONITA VISTA WAY APT 202
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-7429
Mailing Address - Country:US
Mailing Address - Phone:813-585-2493
Mailing Address - Fax:
Practice Address - Street 1:7393 BONITA VISTA WAY APT 202
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-7429
Practice Address - Country:US
Practice Address - Phone:813-585-2493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program