MEDICARE: FI-TAMPA, 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	314000000X	Skilled Nursing Facility	SNF12340961	FL

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	:	1255335857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FI-TAMPA, LLC

Provider Business Mailing Address
First Line	:	1665 PALM BEACH LAKES BLVD STE 400
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-2108
Country	:	US
Telephone Number	:	561-801-7600
Fax Number	:	414-268-4811

Provider Business Practice Location Address
First Line	:	4411 N HABANA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-7211
Country	:	US
Telephone Number	:	813-872-2771
Fax Number	:	813-871-2831

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HOWARD JAFFE
Credential	:
Telephone Number	:	215-346-6454

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	06/11/2025

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