Provider Demographics
NPI:1659032746
Name:OLALEYE, KEHINDE TOLULOPE
Entity Type:Individual
Prefix:
First Name:KEHINDE
Middle Name:TOLULOPE
Last Name:OLALEYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KEHINDE
Other - Middle Name:TOLULOPE
Other - Last Name:ADEYEMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10907 OBSERVATORY WAY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3583
Mailing Address - Country:US
Mailing Address - Phone:813-650-1587
Mailing Address - Fax:
Practice Address - Street 1:15267 AMBERLY DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2155
Practice Address - Country:US
Practice Address - Phone:813-972-5414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-01
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11015452363LF0000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily