Provider Demographics
NPI:1396026175
Name:AYILEKA, ADESOLA ADEOLA
Entity Type:Individual
Prefix:MRS
First Name:ADESOLA
Middle Name:ADEOLA
Last Name:AYILEKA
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 1:3810 SULLIVAN ST
Mailing Address - Street 2:SUIT N &O
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-1762
Mailing Address - Country:US
Mailing Address - Phone:256-325-5345
Mailing Address - Fax:
Practice Address - Street 1:3810 SULLIVAN ST
Practice Address - Street 2:SUIT N&O
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-1762
Practice Address - Country:US
Practice Address - Phone:256-325-5345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL101870171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications