Provider Demographics
NPI:1972922177
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:OWNER
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 1:1106 E RICHMERE ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-8552
Mailing Address - Country:US
Mailing Address - Phone:813-732-0990
Mailing Address - Fax:
Practice Address - Street 1:1106 E RICHMERE ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-8552
Practice Address - Country:US
Practice Address - Phone:813-732-0990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11662310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL005456100Medicaid