Provider Demographics
NPI:1104360544
Name:THOMAS, OLAPEJU
Entity Type:Individual
Prefix:
First Name:OLAPEJU
Middle Name:
Last Name:THOMAS
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 1:841 N LAKE CLAIRE CIR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8489
Mailing Address - Country:US
Mailing Address - Phone:407-683-0707
Mailing Address - Fax:
Practice Address - Street 1:841 N LAKE CLAIRE CIR
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8489
Practice Address - Country:US
Practice Address - Phone:407-683-0707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-04
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3043472163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health