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General NPI Number Information
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NPI Number | 1609523604
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Entity Type | Organization
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Legal Business Name | ABUNDANT LIFE HOME HEALTH AGENCY,LLC
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Dates
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Enumeration Date | 03/09/2022
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 5331 PRIMROSE LAKE CIR 125
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City | TAMPA
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State | FL
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Zip | 33647
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Country | US
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Telephone | 727-286-8916
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Fax | 727-724-1201
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Provider Business Mailing Address
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Address Line | 5331 PRIMROSE LAKE CIR 125
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City | TAMPA
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State | FL
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Zip | 33647-3597
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Country | US
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Telephone | 727-286-8916
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Fax | 727-724-1201
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | TRACI BRISSETT
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Credential | RN
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Telephone | 727-286-8916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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