Active NPI
Oyedele Austin Eniayedun
- Assisted Living Facility
- Orlando, FL
National Provider Identifier
1083097505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- AL12600
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| AL12600 | FL | MD | Assisted 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.