Individual
MR. JAMES A FAGBODUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ADMINISTRATOR
Contact information
Practice address
10648 LUCAYA DR, TAMPA, FL 33647-3530
(813) 230-7628
(813) 991-9749
Mailing address
10648 LUCAYA DR, TAMPA, FL 33647-3530
(813) 230-7628
(813) 991-9749
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
FL
Other
Enumeration date
06/23/2016
Last updated
07/04/2016
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