MEDICARE: ADOL GROUP SERVICES 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	251C00000X	Developmentally Disabled Services Day Training Agency
2	261QD1600X	Developmental Disabilities Clinic/Center

General Provider Information

NPI Number	:	1548054133
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADOL GROUP SERVICES LLC

Provider Business Mailing Address
First Line	:	10619 BLUE CORAL LN
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3664
Country	:	US
Telephone Number	:	813-451-1634
Fax Number	:

Provider Business Practice Location Address
First Line	:	3718 N 53RD ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-1422
Country	:	US
Telephone Number	:	813-451-1634
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	OLORUNNIMBE OLORUNTOBO
Credential	:
Telephone Number	:	813-451-1634

Provider Enumeration Date	:	04/08/2025
Last Update Date	:	05/13/2026

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