Provider Demographics
NPI:1083046692
Name:APATA, ALIRAT OLAITAN
Entity Type:Individual
Prefix:
First Name:ALIRAT
Middle Name:OLAITAN
Last Name:APATA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 E HUMPHREY ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-2027
Mailing Address - Country:US
Mailing Address - Phone:813-458-2805
Mailing Address - Fax:
Practice Address - Street 1:1803 E HUMPHREY ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-2027
Practice Address - Country:US
Practice Address - Phone:813-458-2805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant