Provider Demographics
NPI:1619771839
Name:MASADASA, LLC
Entity type:Organization
Organization Name:MASADASA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SABINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORPEAU DUVIVIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-377-7332
Mailing Address - Street 1:243 KNOLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-8744
Mailing Address - Country:US
Mailing Address - Phone:754-207-7179
Mailing Address - Fax:
Practice Address - Street 1:2295 S HIAWASSEE RD STE 104
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-8748
Practice Address - Country:US
Practice Address - Phone:754-377-7332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)