Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | ME89212 | FL |
NPI | 1194808022 |
---|---|
Provider Name | Dr. Afolabi Olakunle Sangosanya |
First Address | Pensacola, FL 32501-6339 |
Second Address | Pensacola, FL 32501-6339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 16/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000619400 | (05) | FL |