Healthcare Provider Details

I. General information

NPI: 1215865746
Provider Name (Legal Business Name): KUNMILAYO OLAITAN OLAYEYE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 DEL PRADO BLVD STE 1
CAPE CORAL FL
33990-5616
US

IV. Provider business mailing address

23 WRANGLER PASS DR
SPRING TX
77389-5133
US

V. Phone/Fax

Practice location:
  • Phone: 609-209-4660
  • Fax:
Mailing address:
  • Phone: 832-360-4019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: