Provider Demographics
NPI:1396189601
Name:TAMPA MOBILITY LLC
Entity Type:Organization
Organization Name:TAMPA MOBILITY LLC
Other - Org Name:101 MOBILITY INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CLOUSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-815-2737
Mailing Address - Street 1:31171 WATER LILY DR
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34602-7724
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18786 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-3024
Practice Address - Country:US
Practice Address - Phone:305-815-2737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL37-8016160081-5332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies