MEDICARE: TOBI ODEBO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1184353492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOBI ODEBO

Provider Business Mailing Address
First Line	:	2023 RANDOLPH RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-1467
Country	:	US
Telephone Number	:	646-641-8831
Fax Number	:

Provider Business Practice Location Address
First Line	:	2023 RANDOLPH RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-1467
Country	:	US
Telephone Number	:	646-641-8831
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2022
Last Update Date	:	06/10/2022

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Directions to “ TOBI ODEBO ” Practice Location

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