Healthcare Provider Details

I. General information

NPI: 1457796575
Provider Name (Legal Business Name): ABUELO'S HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 12/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1248 E HILLSBOROUGH AVE 226
TAMPA FL
33604-7201
US

IV. Provider business mailing address

1248 E HILLSBOROUGH AVE 226
TAMPA FL
33604-7201
US

V. Phone/Fax

Practice location:
  • Phone: 813-443-8353
  • Fax: 813-443-8364
Mailing address:
  • Phone: 813-443-8353
  • Fax: 813-443-8364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateFL

VIII. Authorized Official

Name: LISANDRA HERNANDEZ
Title or Position: CEO
Credential:
Phone: 813-270-6040