Healthcare Provider Details

I. General information

NPI: 1912811944
Provider Name (Legal Business Name): ABUNDANT&COMFORT LIVING,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4702 GRAINARY AVE
TAMPA FL
33624-2106
US

IV. Provider business mailing address

4702 GRAINARY AVE
TAMPA FL
33624-2106
US

V. Phone/Fax

Practice location:
  • Phone: 656-204-0114
  • Fax: 833-964-0924
Mailing address:
  • Phone: 656-204-0114
  • Fax: 833-964-0924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateNULL

VIII. Authorized Official

Name: MADELAINE PEREZ
Title or Position: OWNER
Credential:
Phone: 656-204-0114