Provider Demographics
NPI:1013774637
Name:ADOUASOTI, DJIBRIL
Entity Type:Individual
Prefix:
First Name:DJIBRIL
Middle Name:
Last Name:ADOUASOTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6150 STUMPH RD APT 112
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44130-1875
Mailing Address - Country:US
Mailing Address - Phone:216-272-6210
Mailing Address - Fax:
Practice Address - Street 1:6150 STUMPH RD APT 112
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44130-1875
Practice Address - Country:US
Practice Address - Phone:216-272-6210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHVD251376374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide