Provider Demographics
NPI:1124161260
Name:AFOLABI, ALADE B (ARNP DNP)
Entity type:Individual
Prefix:DR
First Name:ALADE
Middle Name:B
Last Name:AFOLABI
Suffix:
Gender:M
Credentials:ARNP DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15181 NW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1800
Mailing Address - Country:US
Mailing Address - Phone:954-658-4088
Mailing Address - Fax:
Practice Address - Street 1:1140 NE 163RD ST
Practice Address - Street 2:SUITE NUMBER 26
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4517
Practice Address - Country:US
Practice Address - Phone:954-658-4088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2017-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1941022363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304966301Medicaid
FLP06819Medicare UPIN