Provider Demographics
NPI:1710405139
Name:OYEOTAN, JAMES OLANREWAJU
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:OLANREWAJU
Last Name:OYEOTAN
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:PO BOX 130058
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33681-0058
Mailing Address - Country:US
Mailing Address - Phone:813-331-9485
Mailing Address - Fax:
Practice Address - Street 1:3802 W WALLACE AVE APT 202
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-3569
Practice Address - Country:US
Practice Address - Phone:813-331-9485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-06
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care