MEDICARE: BLESSING ANGELS ASSISTED LIVING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1730061474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLESSING ANGELS ASSISTED LIVING LLC

Provider Business Mailing Address
First Line	:	12234 FAIRLAWN DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33579-3909
Country	:	US
Telephone Number	:	786-804-7431
Fax Number	:

Provider Business Practice Location Address
First Line	:	12234 FAIRLAWN DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33579-3909
Country	:	US
Telephone Number	:	786-804-7431
Fax Number	:	813-875-6745

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	YANET M SAGO ARREBATO
Credential	:
Telephone Number	:	786-804-7431

Provider Enumeration Date	:	07/23/2025
Last Update Date	:	07/23/2025

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