Basic Information
Provider Information
NPI: 1265538821
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OYOLA
FirstName: FELIX
MiddleName: DANIEL
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4930 E LAKE MARY BLVD
Address2:  
City: SANFORD
State: FL
PostalCode: 327715003
CountryCode: US
TelephoneNumber: 4073228645
FaxNumber: 4073228645
Practice Location
Address1: 5449 S SEMORAN BLVD STE 14
Address2:  
City: ORLANDO
State: FL
PostalCode: 328221778
CountryCode: US
TelephoneNumber: 4073228645
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/14/2006
LastUpdateDate: 09/03/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/03/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XME59691FLY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
05522750005FL MEDICAID


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