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General NPI Number Information
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NPI Number | 1184412405
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Entity Type | Individual
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Provider Name | MR. OLAITAN ODENIYI
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Gender | Male
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Dates
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Enumeration Date | 04/28/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 2287 CALLAWAY CT STE 1
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City | DAVENPORT
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State | FL
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Zip | 33837-1733
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Country | US
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Telephone | 774-262-0106
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Fax |
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Provider Business Mailing Address
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Address Line | 10266 CURRY FORD ROAD SUITE 107 PMB 1016
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City | ORLANDO
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State | FL
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Zip | 32825
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Country | US
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Telephone | 774-262-0106
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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