Provider Demographics
NPI:1598356776
Name:OGUNTOYINBO, EBUNOLA HELEN (RPH)
Entity Type:Individual
Prefix:DR
First Name:EBUNOLA
Middle Name:HELEN
Last Name:OGUNTOYINBO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:DR
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:OGUNTOYINBO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:884 NE 72ND STREET
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138
Mailing Address - Country:US
Mailing Address - Phone:305-308-4419
Mailing Address - Fax:
Practice Address - Street 1:884 NE 72ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-5728
Practice Address - Country:US
Practice Address - Phone:305-308-4419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52774183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist