Provider Demographics
NPI:1326740234
Name:ALIU, OSAYANDE
Entity Type:Individual
Prefix:
First Name:OSAYANDE
Middle Name:
Last Name:ALIU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 BLACKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:GOTHA
Mailing Address - State:FL
Mailing Address - Zip Code:34734-4557
Mailing Address - Country:US
Mailing Address - Phone:407-340-3775
Mailing Address - Fax:
Practice Address - Street 1:2808 ENTERPRISE RD STE 105
Practice Address - Street 2:
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-2753
Practice Address - Country:US
Practice Address - Phone:321-347-8475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool