Provider Demographics
NPI:1215720248
Name:OLAOYE, OLAOLUWAPO OLATOKUNBO (PMHNP)
Entity type:Individual
Prefix:
First Name:OLAOLUWAPO
Middle Name:OLATOKUNBO
Last Name:OLAOYE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16000 PINES BLVD UNIT 820904
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33082-9225
Mailing Address - Country:US
Mailing Address - Phone:512-210-0040
Mailing Address - Fax:
Practice Address - Street 1:1538 NW 159TH AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1696
Practice Address - Country:US
Practice Address - Phone:512-210-0040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11039733363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty