Healthcare Provider Details

I. General information

NPI: 1538006804
Provider Name (Legal Business Name): JOY FATOKUN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 NW 13TH ST STE A
GAINESVILLE FL
32601-4087
US

IV. Provider business mailing address

12596 NW 7TH PL
NEWBERRY FL
32669-0170
US

V. Phone/Fax

Practice location:
  • Phone: 352-231-5526
  • Fax:
Mailing address:
  • Phone: 352-709-0165
  • 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 StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: