MEDICARE: A&J ALF OF FLORIDA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility		FL

General Provider Information

NPI Number	:	1073870119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A&J ALF OF FLORIDA INC

Provider Business Mailing Address
First Line	:	2466 RALPH AVE SE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32909-6085
Country	:	US
Telephone Number	:	754-245-3745
Fax Number	:	321-729-9331

Provider Business Practice Location Address
First Line	:	2466 RALPH AVE SE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32909-6085
Country	:	US
Telephone Number	:	754-245-3745
Fax Number	:	321-729-9331

Authorized Official
Title or Position	:	ADMINISTTATOR
Name	:	ANGELLA R SPENCE
Credential	:
Telephone Number	:	754-245-3745

Provider Enumeration Date	:	04/13/2012
Last Update Date	:	07/21/2022

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