Provider Demographics
NPI:1841201753
Name:SONOIKI, OLUYEMISI ADEOLA (MD)
Entity type:Individual
Prefix:
First Name:OLUYEMISI
Middle Name:ADEOLA
Last Name:SONOIKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6525 3RD ST STE 106
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-5751
Mailing Address - Country:US
Mailing Address - Phone:321-307-9400
Mailing Address - Fax:321-622-3036
Practice Address - Street 1:6525 3RD ST STE 106
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-5751
Practice Address - Country:US
Practice Address - Phone:321-307-9400
Practice Address - Fax:321-622-3036
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94933208D00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275425800Medicaid
FL275425800Medicaid