Provider Demographics
NPI:1427335793
Name:SULEIMAN, AYODEJI H
Entity type:Individual
Prefix:MR
First Name:AYODEJI
Middle Name:H
Last Name:SULEIMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9005 PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6440
Mailing Address - Country:US
Mailing Address - Phone:954-392-4749
Mailing Address - Fax:954-392-8010
Practice Address - Street 1:9005 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6440
Practice Address - Country:US
Practice Address - Phone:954-392-4749
Practice Address - Fax:954-392-8010
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40475183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist