Provider Demographics
NPI:1659242360
Name:IKUMAWOYI, IFEOLUWA SUSANNA (PT, DPT)
Entity type:Individual
Prefix:
First Name:IFEOLUWA
Middle Name:SUSANNA
Last Name:IKUMAWOYI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2670 FOREST HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5972
Mailing Address - Country:US
Mailing Address - Phone:561-968-9100
Mailing Address - Fax:
Practice Address - Street 1:2670 FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5972
Practice Address - Country:US
Practice Address - Phone:561-968-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-16
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT43632225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist