Healthcare Provider Details

I. General information

NPI: 1285591867
Provider Name (Legal Business Name): BLUE OASIS OF FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5713 S MACDILL AVE
TAMPA FL
33611-4481
US

IV. Provider business mailing address

1645 SUN CITY CENTER PLZ UNIT 5774
SUN CITY CENTER FL
33571-8032
US

V. Phone/Fax

Practice location:
  • Phone: 813-542-8088
  • Fax:
Mailing address:
  • Phone: 813-542-8088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: TINIKA HAMMOND
Title or Position: PRESIDENT
Credential:
Phone: 813-542-8088