Provider Demographics
NPI:1689181208
Name:FAMILY SOARING
Entity Type:Organization
Organization Name:FAMILY SOARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EVANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-564-7769
Mailing Address - Street 1:10800 BRIGHTON BAY BLVD NE
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-3478
Mailing Address - Country:US
Mailing Address - Phone:727-564-7769
Mailing Address - Fax:727-800-5144
Practice Address - Street 1:10800 BRIGHTON BAY BLVD NE
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-3478
Practice Address - Country:US
Practice Address - Phone:727-564-7769
Practice Address - Fax:727-800-5144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-04
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7304253Z00000X
376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty