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General NPI Number Information
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NPI Number | 1437677978
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Entity Type | Organization
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Legal Business Name | HOUSE CALLS MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 09/05/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1130 6TH ST NW
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City | WINTER HAVEN
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State | FL
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Zip | 33881-4021
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Country | US
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Telephone | 813-410-4873
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Fax |
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Provider Business Mailing Address
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Address Line | 1130 6TH ST NW
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City | WINTER HAVEN
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State | FL
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Zip | 33881-4021
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Country | US
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Telephone | 813-410-4873
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ENIOLA AYOOLA
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Credential | PA, PHD
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Telephone | 813-410-4873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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