Provider Demographics
NPI:1093593360
Name:ABUNDANCE HEALTHCARE LLC
Entity Type:Organization
Organization Name:ABUNDANCE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASMINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHOATS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-215-9483
Mailing Address - Street 1:10948 N 56TH ST STE 206
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-3001
Mailing Address - Country:US
Mailing Address - Phone:813-215-9483
Mailing Address - Fax:
Practice Address - Street 1:10948 N 56TH ST STE 206
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-3001
Practice Address - Country:US
Practice Address - Phone:813-215-9483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-18
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care