Organization
ABUNDANT LIFE HOME HEALTH AGENCY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI BRISSETT RN (DIRECTOR OF NURSING)
(727) 286-8916
Entity
Organization
Contact information
Practice address
5331 PRIMROSE LAKE CIR, 125, TAMPA, FL 33647
(727) 286-8916
(727) 724-1201
Mailing address
5331 PRIMROSE LAKE CIR, 125, TAMPA, FL 33647-3597
(727) 286-8916
(727) 724-1201
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111860500
—
FL
01
—
299994461
AHCA LICENSE
FL
Enumeration date
03/09/2022
Last updated
01/02/2026
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