| Sos Mobile Medical Care Llc | |
|
16025 Muirfield Dr Odessa FL 33556-2861 | |
| (813) 226-3332 | |
| (813) 793-7644 |
| Full Name | Sos Mobile Medical Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 16025 Muirfield Dr, Odessa, Florida |
| Authorized Official Name and Position | Joshua Edward Kolanko (OWNER/NURSE PRACTITIONER) |
| Authorized Official Contact | 8132263332 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sos Mobile Medical Care Llc Po Box 22 Odessa FL 33556-0022 Ph: (813) 226-3332 | Sos Mobile Medical Care Llc 16025 Muirfield Dr Odessa FL 33556-2861 Ph: (813) 226-3332 |
| NPI Number | 1770239162 |
|---|---|
| Provider Enumeration Date | 02/24/2022 |
| Last Update Date | 02/24/2022 |
| Medicare PECOS PAC ID | 6305212374 |
|---|---|
| Medicare Enrollment ID | O20221017000085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770239162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Joshua Kolanko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821086745 PECOS PAC ID: 8224029608 Enrollment ID: I20040524000595 |
| Provider Name | Roderick Bennett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629166137 PECOS PAC ID: 8729002233 Enrollment ID: I20070917000038 |
| Provider Name | Damon A Ferreira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700292653 PECOS PAC ID: 1951521137 Enrollment ID: I20141010000954 |
| Provider Name | Joel E Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992180582 PECOS PAC ID: 5597065367 Enrollment ID: I20151201000053 |
| Provider Name | Nikalina Leliea Dundas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942920251 PECOS PAC ID: 2365809878 Enrollment ID: I20230526001307 |
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