Provider Demographics
NPI:1184412405
Name:ODENIYI, OLAITAN
Entity type:Individual
Prefix:MR
First Name:OLAITAN
Middle Name:
Last Name:ODENIYI
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 1:10266 CURRY FORD ROAD
Mailing Address - Street 2:SUITE 107 PMB 1016
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825
Mailing Address - Country:US
Mailing Address - Phone:774-262-0106
Mailing Address - Fax:
Practice Address - Street 1:2287 CALLAWAY CT STE 1
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-1733
Practice Address - Country:US
Practice Address - Phone:774-262-0106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker