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Individual

LAUREL OLAJIDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
13119 FENNWAY RIDGE DR, RIVERVIEW, FL 33579-7160
(813) 579-0243
Mailing address
13119 FENNWAY RIDGE DR, RIVERVIEW, FL 33579-7160

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906833
FL

Other

Enumeration date
05/11/2016
Last updated
05/11/2016
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