Provider Demographics
NPI:1467236455
Name:OKE, ADEBAYO (DPT)
Entity Type:Individual
Prefix:
First Name:ADEBAYO
Middle Name:
Last Name:OKE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3052 BLAINE CIR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-5329
Mailing Address - Country:US
Mailing Address - Phone:386-847-6585
Mailing Address - Fax:
Practice Address - Street 1:151 VICTORIA COMMONS BLVD STE 107
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-7722
Practice Address - Country:US
Practice Address - Phone:386-943-4690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT40528225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist