Provider Demographics
NPI:1912502816
Name:OLAYEMI, ARIYOOSU ADELEKE
Entity Type:Individual
Prefix:
First Name:ARIYOOSU
Middle Name:ADELEKE
Last Name:OLAYEMI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 APPLE BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-4401
Mailing Address - Country:US
Mailing Address - Phone:954-560-6413
Mailing Address - Fax:
Practice Address - Street 1:3580 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-6608
Practice Address - Country:US
Practice Address - Phone:954-943-3244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38908183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist