Provider Demographics
NPI:1174965040
Name:A TROPICAL PARADISE ALF LLC
Entity type:Organization
Organization Name:A TROPICAL PARADISE ALF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALF OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MEINICHUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-498-6262
Mailing Address - Street 1:5228 23RD AVE N
Mailing Address - Street 2:
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710
Mailing Address - Country:US
Mailing Address - Phone:727-498-6262
Mailing Address - Fax:727-291-0252
Practice Address - Street 1:5228 23RD AVE N
Practice Address - Street 2:
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710
Practice Address - Country:US
Practice Address - Phone:727-498-6262
Practice Address - Fax:727-291-0252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-21
Last Update Date:2022-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11367310400000X
310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110402300Medicaid