Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | ME72374 | FL |
NPI | 1063522332 |
---|---|
Provider Name | Dr. Olayemi Olajide Osiyemi |
First Address | West Palm Beach, FL 33407-3100 |
Second Address | West Palm Beach, FL 33407-3100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 19/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
258949400 | (05) | FL |
H23486 | (02) | FL |