Provider Demographics
NPI:1841611274
Name:FLO-RONKE INC.
Entity Type:Organization
Organization Name:FLO-RONKE INC.
Other - Org Name:AMAZING GRACE ASSISTED LIVING FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINTOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-732-0990
Mailing Address - Street 1:1513 E ELLICOTT ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-4915
Mailing Address - Country:US
Mailing Address - Phone:813-238-6051
Mailing Address - Fax:813-657-0763
Practice Address - Street 1:1513 E ELLICOTT ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-4915
Practice Address - Country:US
Practice Address - Phone:813-238-6051
Practice Address - Fax:813-657-0763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL140337100Medicaid
FL005456100Medicaid