Healthcare Provider Details

I. General information

NPI: 1598687352
Provider Name (Legal Business Name): ROYAL BLUE ASSISTED LIVING FACILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4327 SMUGGLERS WAY
JACKSONVILLE FL
32210-7309
US

IV. Provider business mailing address

4327 SMUGGLERS WAY
JACKSONVILLE FL
32210-7309
US

V. Phone/Fax

Practice location:
  • Phone: 904-240-0228
  • Fax: 904-240-0228
Mailing address:
  • Phone: 904-240-0228
  • Fax: 904-240-0228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. AKINTOLA MICHAEL SHENBANJO II II
Title or Position: ADMINISTRATOR
Credential:
Phone: 904-240-0228