Provider Demographics
NPI:1891184099
Name:OWI, ENIBOKUN OSAYAWE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ENIBOKUN
Middle Name:OSAYAWE
Last Name:OWI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:ENIBOKUN
Other - Middle Name:
Other - Last Name:OSAYAWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3481 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-1628
Mailing Address - Country:US
Mailing Address - Phone:954-542-2800
Mailing Address - Fax:
Practice Address - Street 1:3481 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-1628
Practice Address - Country:US
Practice Address - Phone:954-542-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9300611363L00000X
FLAPRN9300611363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0242507400Medicaid