Healthcare Provider Details

I. General information

NPI: 1780389601
Provider Name (Legal Business Name): EMPATH LIFE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5414 BEAUMONT CENTER BLVD
TAMPA FL
33634-5266
US

IV. Provider business mailing address

5771 ROOSEVELT BLVD
CLEARWATER FL
33760-3407
US

V. Phone/Fax

Practice location:
  • Phone: 727-586-4432
  • Fax:
Mailing address:
  • Phone: 727-586-4432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: SAIDA BOUHAMID
Title or Position: CFO
Credential:
Phone: 941-552-7500