Mutiu, Omoniyi Fatai

Mutiu, Omoniyi Fatai is an individual health care provider with primary practice located at 1400 E Oakland Park Blvd Ste 210 , Oakland Park FL 33334-4400. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Mutiu, Omoniyi Fatai can be contacted via phone (954) 561-6222.

Contact Information

Primary practice address
1400 E Oakland Park Blvd Ste 210 Oakland Park FL 33334-4400
Phone: (954) 561-6222
Fax: (954) 990-7650
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP9326452 Florida
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 364SP0808X ARNP9326452 Florida
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X ARNP9326452 Florida

Profile Details

NPI number 1396247359
LBN Legal business name Mutiu, Omoniyi Fatai
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2018
Last updated Oct 8th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396247359 NPPES
Florida MEDICAID 024364200

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