Provider Demographics
NPI:1215701198
Name:AJEKIGBE, OMOLOLA RHODA
Entity type:Individual
Prefix:
First Name:OMOLOLA
Middle Name:RHODA
Last Name:AJEKIGBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:OMOLOLA
Other - Middle Name:RHODA
Other - Last Name:OGUNSIJI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5375 N 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8725
Mailing Address - Country:US
Mailing Address - Phone:850-941-7841
Mailing Address - Fax:
Practice Address - Street 1:5375 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8725
Practice Address - Country:US
Practice Address - Phone:850-941-7841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-10
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP125274207Q00000X, 207R00000X
FL42826208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine