Healthcare Provider Details

I. General information

NPI: 1639089519
Provider Name (Legal Business Name): PALM AVENUE BT, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E PALM AVE
TAMPA FL
33602-2236
US

IV. Provider business mailing address

215 E PALM AVE
TAMPA FL
33602-2236
US

V. Phone/Fax

Practice location:
  • Phone: 813-223-2686
  • Fax: 813-223-6983
Mailing address:
  • Phone: 813-223-2686
  • Fax: 813-223-6983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: LINA OROZCO
Title or Position: ASSISTED LIVING DIRECTOR
Credential:
Phone: 813-995-1605