Provider Demographics
NPI:1669759908
Name:OJEABULU, GANIAT OLUWAMAYOWA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GANIAT
Middle Name:OLUWAMAYOWA
Last Name:OJEABULU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 ROCKS POINT PL
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-1103
Mailing Address - Country:US
Mailing Address - Phone:786-877-9297
Mailing Address - Fax:
Practice Address - Street 1:4001 ROCKS POINT PL
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-1103
Practice Address - Country:US
Practice Address - Phone:786-877-9297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSP40758183500000X
TX49832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist