Healthcare Provider Details

I. General information

NPI: 1730094186
Provider Name (Legal Business Name): BEACHAM OASIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8464 EMILY WOOD CIR
TAMPA FL
33647
US

IV. Provider business mailing address

27251 WESLEY CHAPEL BLVD STE 1021
WESLEY CHAPEL FL
33544-4285
US

V. Phone/Fax

Practice location:
  • Phone: 813-647-8802
  • Fax:
Mailing address:
  • Phone: 813-647-8802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY BEACHAM
Title or Position: OWNER
Credential:
Phone: 813-647-8802