Provider Demographics
NPI:1730437989
Name:OLAYINKA, JODY FAYE (BSW)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:FAYE
Last Name:OLAYINKA
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14270 80TH LN N
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-4380
Mailing Address - Country:US
Mailing Address - Phone:561-635-1486
Mailing Address - Fax:
Practice Address - Street 1:14270 80TH LN N
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-4380
Practice Address - Country:US
Practice Address - Phone:561-635-1486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-20
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014671800Medicaid