Provider Demographics
NPI:1760284244
Name:KAYODE, OMOBOLANLE (MD)
Entity type:Individual
Prefix:
First Name:OMOBOLANLE
Middle Name:
Last Name:KAYODE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10623 153RD ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11433-1915
Mailing Address - Country:US
Mailing Address - Phone:347-624-0350
Mailing Address - Fax:
Practice Address - Street 1:4228 HOUMA BLVD STE 230
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-3020
Practice Address - Country:US
Practice Address - Phone:504-454-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program