Provider Demographics
NPI:1588937312
Name:SOBANDE, OLUTOLA AKINOLA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:OLUTOLA
Middle Name:AKINOLA
Last Name:SOBANDE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17671 SW 4TH CT
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-4016
Mailing Address - Country:US
Mailing Address - Phone:954-817-3788
Mailing Address - Fax:
Practice Address - Street 1:17671 SW 4TH CT
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-4016
Practice Address - Country:US
Practice Address - Phone:954-817-3788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 32389183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist