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General NPI Number Information
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NPI Number | 1700405412
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Entity Type | Organization
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Legal Business Name | THE ABIGAIL ASSISTED LIVING
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 04/13/2020
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Provider Practice Location Address
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Address Line | 320 S DELAWARE AVE
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City | TAMPA
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State | FL
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Zip | 33606-2106
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Country | US
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Telephone | 813-258-2919
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Fax |
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Provider Business Mailing Address
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Address Line | 2626 N DUNDEE ST
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City | TAMPA
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State | FL
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Zip | 33629-7517
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Country | US
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Telephone | 813-810-2118
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KAREN BARCIA RODRIGUEZ
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Credential |
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Telephone | 813-258-2919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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