Healthcare Provider Details

I. General information

NPI: 1205506201
Provider Name (Legal Business Name): DEBORAH LYNN OLORUNFEMI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 EDGEWATER DR STE 6003
ORLANDO FL
32804-6350
US

IV. Provider business mailing address

1317 EDGEWATER DR STE 6003
ORLANDO FL
32804-6350
US

V. Phone/Fax

Practice location:
  • Phone: 386-753-4245
  • Fax:
Mailing address:
  • Phone: 386-753-4245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: