Provider Demographics
NPI:1982326229
Name:AKINTUNDE-AKINWOLE, REGINAH (APRN, RN)
Entity Type:Individual
Prefix:
First Name:REGINAH
Middle Name:
Last Name:AKINTUNDE-AKINWOLE
Suffix:
Gender:F
Credentials:APRN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16242 SW 18TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4456
Mailing Address - Country:US
Mailing Address - Phone:954-438-8334
Mailing Address - Fax:
Practice Address - Street 1:16242 SW 18TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4456
Practice Address - Country:US
Practice Address - Phone:954-438-8334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005089363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily