TINUADE OLUSEGUN M.D. NPI 1760649917

NPI Information

  • NPI: 1760649917
  • Provider Name: TINUADE OLUSEGUN, M.D.
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4645 CLYDE MORRIS BLVD STE 404
    PORT ORANGE, FL
    ZIP 32129
  • Phone: (386) 855-8633

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NPI Details

Tinuade Olusegun, M.D. is an internal medicine in Port Orange, FL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. Tinuade Olusegun, M.D. NPI is 1760649917. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4645 CLYDE MORRIS BLVD STE 404
PORT ORANGE, FL
ZIP 32129-005
Phone: (386) 855-8633
Fax: (855) 857-5810

The NPI 1760649917 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/16/2008 and was last updated on 12/13/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineN3663TEXASNo
2207R00000XInternal MedicineME137495FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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