Provider Demographics
NPI:1609121458
Name:WHITE FLOWERS ALF
Entity Type:Organization
Organization Name:WHITE FLOWERS ALF
Other - Org Name:BLANCA FLORES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINSTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-207-7165
Mailing Address - Street 1:801 ARDENLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-8655
Mailing Address - Country:US
Mailing Address - Phone:407-207-7165
Mailing Address - Fax:407-207-3431
Practice Address - Street 1:801 ARDENLEIGH DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-8655
Practice Address - Country:US
Practice Address - Phone:407-207-7165
Practice Address - Fax:407-207-3431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11036310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility