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General NPI Number Information
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NPI Number | 1942383450
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Entity Type | Individual
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Provider Name | OLATUNDE ORE FATINIKUN M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/21/2006
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 792 CACTUS RIDGE CIRCLE SUITE B
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City | SEFFNER
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State | FL
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Zip | 33584-5751
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Country | US
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Telephone | 813-445-5538
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Fax | 877-576-6793
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Provider Business Mailing Address
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Address Line | 792 CACTUS RIDGE CIRCLE SUITE B
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City | SEFFNER
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State | FL
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Zip | 33584-5751
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Country | US
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Telephone | 813-445-5538
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Fax | 877-576-6793
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | ME157788
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 35084081
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35.084081
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License Number State | OH
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