OLAYINKA BANKOLE MD PA
Osteopathic Medicine in Tampa, FL

License number
Florida ME69767
Category
Osteopathic Medicine
Type
Internal Medicine
License number
Florida ME69767
Category
Osteopathic Medicine
Type
Obesity Medicine
Owner
Name: OLAYINKA BANKOLE M.D.
Title: PRESIDENT
Phone: (813) 414-0825
Address
Address
4204 N Macdill Ave # B SUITE 2, Tampa, FL 33607
National Provider ID: 1831378371
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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OLAYINKA BANKOLE, M.D., PA

Tampa, FL

Status:
Inactive
Inactive reason:
REINSTATEMENT
Registration:
Mar 22, 1999
Inactive since:
Oct 9, 2010
Addresses:
2901 W Saint Isabel St D, Tampa, FL 33607 (Physical)
2901 W Saint Isabel St, Tampa, FL 33607
4204 N Macdill Ave, Tampa, FL 33607
State ID:
P99000028127
Business type:
Florida Profit Corporation
President, Director:
Olayinka Bankole (President, Director), 2901 W Saint Isabel St, Tampa, FL 33607 (Physical)
Agent:
Bankole, Olayinka,2901 W Saint Isabel St, Tampa, FL 33607 (Physical)
EIN:
593563622

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