Provider Demographics
NPI:1518597798
Name:A AKINYEMI MD
Entity Type:Organization
Organization Name:A AKINYEMI MD
Other - Org Name:MINDSET BEHAVIORAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AKINBOYEDE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINYEMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-888-2109
Mailing Address - Street 1:1111 SE FEDERAL HWY STE 130
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3802
Mailing Address - Country:US
Mailing Address - Phone:772-888-2109
Mailing Address - Fax:772-600-5546
Practice Address - Street 1:1111 SE FEDERAL HWY STE 130
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3802
Practice Address - Country:US
Practice Address - Phone:404-304-5002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-16
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty