MEDICARE: MOBILITY TRANSPORTERS LLC

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	172A00000X	Driver

General Provider Information

NPI Number	:	1396500427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILITY TRANSPORTERS LLC

Provider Business Mailing Address
First Line	:	9722 LAKE CHASE ISLAND WAY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-1946
Country	:	US
Telephone Number	:	813-285-1687
Fax Number	:

Provider Business Practice Location Address
First Line	:	9722 LAKE CHASE ISLAND WAY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-1946
Country	:	US
Telephone Number	:	813-285-1687
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	OLATOKUNBO OSANYINJOBI
Credential	:
Telephone Number	:	813-285-1687

Provider Enumeration Date	:	02/19/2024
Last Update Date	:	02/19/2024

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