Individual provider Active NPI

Oyedele Austin Eniayedun

  • Assisted Living Facility
  • Orlando, FL
National Provider Identifier
1083097505
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL12600 Issued in FL
Practice address
5019 Cassatt Ave
Orlando, FL 32808-1606
Phone
(321) 245-7458
NPI assigned
Jul 1, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL12600 FL Primary

Addresses

Primary practice location

5019 Cassatt Ave
Orlando, FL 32808-1606

Mailing address

5019 Cassatt Ave
Orlando, FL 32808-1606
Phone (321) 245-7458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AL12600FLMDAssisted Living Facility

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1083097505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5019 CASSATT AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328081606",
            "telephone_number": "321-245-7458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5019 CASSATT AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328081606",
            "telephone_number": "321-245-7458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENIAYEDUN",
        "first_name": "OYEDELE",
        "middle_name": "AUSTIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.