MEDICARE: A TROPICAL PARADISE ALF LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	11367	FL
2	310400000X	Assisted Living Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174965040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A TROPICAL PARADISE ALF LLC

Provider Business Mailing Address
First Line	:	5228 23RD AVE N
Second Line	:
City	:	ST. PETERSBURG
State	:	FL
Zip	:	33710
Country	:	US
Telephone Number	:	727-498-6262
Fax Number	:	727-291-0252

Provider Business Practice Location Address
First Line	:	5228 23RD AVE N
Second Line	:
City	:	ST. PETERSBURG
State	:	FL
Zip	:	33710
Country	:	US
Telephone Number	:	727-498-6262
Fax Number	:	727-291-0252

Authorized Official
Title or Position	:	ALF OWNER
Name	:	IGOR MEINICHUK
Credential	:
Telephone Number	:	727-498-6262

Provider Enumeration Date	:	07/21/2013
Last Update Date	:	03/26/2022

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Directions to “A TROPICAL PARADISE ALF LLC ” Practice Location

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