Healthcare Provider Details

I. General information

NPI: 1881130599
Provider Name (Legal Business Name): HOPE 4 LIFE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 08/23/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 OAKFIELD DR STE 213
BRANDON FL
33511-4924
US

IV. Provider business mailing address

1302 HARNESS HORSE LN APT 104
BRANDON FL
33511-3860
US

V. Phone/Fax

Practice location:
  • Phone: 813-438-5122
  • Fax: 813-217-5555
Mailing address:
  • Phone: 813-724-9667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE KRAMER
Title or Position: OWNER
Credential:
Phone: 813-724-9667