Provider Demographics
NPI:1558110767
Name:AKINRIN, OLATUBOSUN SOLOMON
Entity type:Individual
Prefix:
First Name:OLATUBOSUN
Middle Name:SOLOMON
Last Name:AKINRIN
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 1:1358 NW 214TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2027
Mailing Address - Country:US
Mailing Address - Phone:786-318-7225
Mailing Address - Fax:
Practice Address - Street 1:1358 NW 214TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-2027
Practice Address - Country:US
Practice Address - Phone:786-318-7225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11032854363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health