Provider Demographics
NPI:1205475464
Name:OSAIGBOVO, OLAYEMI OLADELE
Entity type:Individual
Prefix:
First Name:OLAYEMI
Middle Name:OLADELE
Last Name:OSAIGBOVO
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 1:2830 SW 83RD TER
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-2973
Mailing Address - Country:US
Mailing Address - Phone:954-608-0560
Mailing Address - Fax:
Practice Address - Street 1:2830 SW 83RD TER
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-2973
Practice Address - Country:US
Practice Address - Phone:954-608-0560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-04
Last Update Date:2020-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant