Healthcare Provider Details

I. General information

NPI: 1659170413
Provider Name (Legal Business Name): CARING HEART TAMPA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3918 S KINGS AVE
BRANDON FL
33511-7749
US

IV. Provider business mailing address

4106 IMPERIAL EAGLE DR
VALRICO FL
33594-3965
US

V. Phone/Fax

Practice location:
  • Phone: 813-662-1535
  • Fax: 813-681-3585
Mailing address:
  • Phone: 813-334-5135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH V ABRAHAM
Title or Position: MANAGING MEMBER
Credential:
Phone: 813-334-5135