Provider Demographics
NPI:1144375197
Name:OYETUNJI, OYEBODE O (RPH)
Entity type:Individual
Prefix:MR
First Name:OYEBODE
Middle Name:O
Last Name:OYETUNJI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-1638
Mailing Address - Country:US
Mailing Address - Phone:954-447-1823
Mailing Address - Fax:954-447-1826
Practice Address - Street 1:9111 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-1638
Practice Address - Country:US
Practice Address - Phone:954-447-1823
Practice Address - Fax:954-447-1826
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS28882183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS28882OtherPHARMACIST LICENSE