Olabanjo J Mobayo

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Practice address

108 Guaymas Dr
Kissimmee, FL 34743-9224

Phone

(770) 256-4384

NPI assigned

Apr 30, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1265015069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 GUAYMAS DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347439224",
            "telephone_number": "770-256-4384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 GUAYMAS DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347439224",
            "telephone_number": "770-256-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBAYO",
        "first_name": "OLABANJO",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "oladaniel1",
            "affiliation": "N",
            "address_1": "108 Guaymas Dr",
            "city": "Kissimmee",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347439224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Adult Care Home Facility in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.