Provider Demographics
NPI:1598571531
Name:BAKARE, AZEEZ O
Entity type:Individual
Prefix:
First Name:AZEEZ
Middle Name:O
Last Name:BAKARE
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 1:3689 HAMMERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3125
Mailing Address - Country:US
Mailing Address - Phone:614-779-7644
Mailing Address - Fax:
Practice Address - Street 1:3689 HAMMERWOOD CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3125
Practice Address - Country:US
Practice Address - Phone:614-779-7644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No251X00000XAgenciesSupports Brokerage