Active NPI
Bristol SNF LLC
- Skilled Nursing Facility
- Tampa, FL
National Provider Identifier
1750967337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- BRISTOL SNF LLC
- Practice address
- 1818 E Fletcher Ave
Tampa, FL 33612-3770 - Phone
- (813) 971-2383
- NPI assigned
- Mar 23, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Bleich
- Title
- Authorized Official
- Phone
- (845) 641-8314
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
1818 E Fletcher Ave
Tampa, FL 33612-3770
Mailing address
400 Rella Blvd Ste 200
Montebello, NY 10901-4239
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210503000584 | FL | Part A Provider - Skilled Nursing Facility | 1254740392 | Practice locations: Tampa, FL |
Skilled nursing facility certification: CCN 105140
- Legal name
- BRISTOL SNF LLC
- Doing business as
- THE BRISTOL CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 9, 1967
- Last certification
- Jan 30, 2025
- Beds
- 266
- Ownership / control type
- Individual
- Organization structure
- Other
- Incorporated
- Feb 11, 2021 in DE
- Enrollment address
- 1818 E Fletcher Ave
Tampa, FL 33612-3770 - Nursing home name
- THE BRISTOL CARE CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- The Bristol Care Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Individual
- Certified
- May 9, 1967
- Medicare certification status
- Active
- Certified beds
- 266
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0890519 | Bristol SNF LLC | Certificate of waiver | Aug 18, 2026 |
National Provider Directory
National Provider DirectoryNetworks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Ownership & related parties
All disclosed owners & managing parties 7
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Gold FL TR | 5% Or Greater Indirect Ownership Interest | Feb 11, 2021 | 20% |
| Jack Y Shelby | 5% Or Greater Indirect Ownership Interest | Feb 11, 2021 | 50% |
| Silver FL TR | 5% Or Greater Indirect Ownership Interest | Feb 11, 2021 | 20% |
| Michael Bleich | Corporate Officer | Feb 11, 2021 | |
| Copper FL TR | 5% Or Greater Indirect Ownership Interest | Feb 11, 2021 | 20% |
| Bristol Holdco LLC | 5% Or Greater Direct Ownership Interest | Feb 11, 2021 | 100% |
| Alvin Jerard Barriner | W-2 Managing Employee | May 15, 2021 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 5
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Tampa, FL
- NPI 1104050640
Nursing home
-
- Geriatric Medicine (Internal Medicine) Physician
- Tampa, FL
- NPI 1568667715
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616457600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1616457600000",
"number": "1750967337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 RELLA BLVD STE 200",
"city": "MONTEBELLO",
"state": "NY",
"postal_code": "109014239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1818 E FLETCHER AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336123770",
"telephone_number": "813-971-2383"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRISTOL SNF LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-03-23",
"last_updated": "2021-03-23",
"certification_date": "2021-03-23",
"status": "A",
"authorized_official_last_name": "BLEICH",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "845-641-8314"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.