Healthcare Provider Details

I. General information

NPI: 1033031810
Provider Name (Legal Business Name): AYODEJI AFODE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 W 49TH PL
HIALEAH FL
33012-3113
US

IV. Provider business mailing address

1475 W 49TH PL
HIALEAH FL
33012-3113
US

V. Phone/Fax

Practice location:
  • Phone: 305-824-4780
  • Fax: 305-824-4780
Mailing address:
  • Phone: 305-824-4780
  • Fax: 305-824-4780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberPS42626
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: