Provider Demographics
NPI:1588086938
Name:ANA ABUELOS ALF
Entity type:Organization
Organization Name:ANA ABUELOS ALF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BATISTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-748-1304
Mailing Address - Street 1:2923 W IVY ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-1924
Mailing Address - Country:US
Mailing Address - Phone:813-748-1304
Mailing Address - Fax:
Practice Address - Street 1:2741 W LEROY ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1249
Practice Address - Country:US
Practice Address - Phone:813-748-1304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABUELOS ANA ALF
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-18
Last Update Date:2014-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11770310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility