Provider Demographics
NPI:1376164970
Name:SPECIAL NEEDS TRANSPORTATION LLC
Entity Type:Organization
Organization Name:SPECIAL NEEDS TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABIDEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADETUTU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-506-0691
Mailing Address - Street 1:8001 N DALE MABRY HWY STE 701
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-3218
Mailing Address - Country:US
Mailing Address - Phone:813-506-0691
Mailing Address - Fax:
Practice Address - Street 1:8001 N DALE MABRY HWY STE 701
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3218
Practice Address - Country:US
Practice Address - Phone:813-506-0691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12191956Other12191956