Provider Demographics
NPI:1922329440
Name:LEYIMU, ENIOLA O (PHARMD)
Entity Type:Individual
Prefix:
First Name:ENIOLA
Middle Name:O
Last Name:LEYIMU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:864 CAMP FRANCIS JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-5808
Mailing Address - Country:US
Mailing Address - Phone:904-276-7531
Mailing Address - Fax:
Practice Address - Street 1:864 CAMP FRANCIS JOHNSON RD
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-5808
Practice Address - Country:US
Practice Address - Phone:904-276-7531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU44791835G0303X
FLPS237101835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric