Provider Demographics
NPI:1790442457
Name:OYEWALE, FLORENCE ADEBUKOLA
Entity Type:Individual
Prefix:
First Name:FLORENCE ADEBUKOLA
Middle Name:
Last Name:OYEWALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3262
Mailing Address - Country:US
Mailing Address - Phone:240-704-3409
Mailing Address - Fax:
Practice Address - Street 1:630 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3262
Practice Address - Country:US
Practice Address - Phone:240-704-3409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide