Individual
OLAMIDE O BORISADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, PMHNP-BC
Contact information
Practice address
309 GLENNEYRE CIR, SAINT AUGUSTINE, FL 32092-1226
(904) 333-1600
Mailing address
4870 DEER LAKE DR E STE 1114, JACKSONVILLE, FL 32246-6301
(904) 866-0148
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11037449
FL
Other
Enumeration date
07/27/2020
Last updated
03/03/2025
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