Healthcare Provider Details

I. General information

NPI: 1346151610
Provider Name (Legal Business Name): MIS ABUELOS COMPANIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3848 SUN CITY CENTER BLV 104 PMB 1053
RUSKIN FL
33573
US

IV. Provider business mailing address

3848 SUN CITY CENTER BLV 104 PMB 1053
RUSKIN FL
33573
US

V. Phone/Fax

Practice location:
  • Phone: 508-680-4630
  • Fax:
Mailing address:
  • Phone: 508-680-4630
  • 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 Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: DANIEL TAVAREZ
Title or Position: OWNER
Credential:
Phone: 508-680-4630