Healthcare Provider Details

I. General information

NPI: 1619414596
Provider Name (Legal Business Name): MOJISOLA FIFO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2017
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 18TH ST NE
WASHINGTON DC
20018-2738
US

IV. Provider business mailing address

3500 18TH ST NE
WASHINGTON DC
20018-2738
US

V. Phone/Fax

Practice location:
  • Phone: 202-529-6510
  • Fax:
Mailing address:
  • Phone: 202-529-6510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberNA00607208
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHAA12079
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: