Provider Demographics
NPI:1922353895
Name:AKINLABI, OLADIMEJI S (PA)
Entity Type:Individual
Prefix:MR
First Name:OLADIMEJI
Middle Name:S
Last Name:AKINLABI
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:OLDIMEJI
Other - Middle Name:S
Other - Last Name:AKINLABI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:800 CLEMATIS ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5107
Mailing Address - Country:US
Mailing Address - Phone:561-671-4099
Mailing Address - Fax:561-837-5332
Practice Address - Street 1:38754 STATE ROAD 80
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-5615
Practice Address - Country:US
Practice Address - Phone:561-996-1600
Practice Address - Fax:561-837-5332
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9100324363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant