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General NPI Number Information
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NPI Number | 1912860941
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Entity Type | Organization
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Legal Business Name | MOBILE DIALYSIS SOLUTIONS LLC
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 12804 EAGLES ENTRY DR
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City | ODESSA
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State | FL
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Zip | 33556-2837
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Country | US
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Telephone | 813-786-0133
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Fax |
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Provider Business Mailing Address
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Address Line | 14910 N DALE MABRY HWY UNIT 340526
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City | TAMPA
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State | FL
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Zip | 33618-1814
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Country | US
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Telephone | 813-786-0133
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | OLAOLU ODEWOLE
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Credential |
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Telephone | 415-200-7986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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