Provider Demographics
NPI:1548743859
Name:OLATUNJI, FEMI
Entity Type:Individual
Prefix:
First Name:FEMI
Middle Name:
Last Name:OLATUNJI
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 1:4525 MAPLETREE LOOP
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-8116
Mailing Address - Country:US
Mailing Address - Phone:813-500-7980
Mailing Address - Fax:
Practice Address - Street 1:4158 MARINER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-2468
Practice Address - Country:US
Practice Address - Phone:352-688-2066
Practice Address - Fax:352-688-9644
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36318183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist