MEDICARE: FLORA ALF 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

General Provider Information

NPI Number	:	1558829366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORA ALF INC.

Provider Business Mailing Address
First Line	:	403 NORTHWEST BLVD
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-4166
Country	:	US
Telephone Number	:	786-362-6046
Fax Number	:	305-551-6894

Provider Business Practice Location Address
First Line	:	403 NORTHWEST BLVD
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-4166
Country	:	US
Telephone Number	:	786-362-6046
Fax Number	:	305-551-6894

Authorized Official
Title or Position	:	OWNER
Name	:	RONAL MARTINEZ FAIFE
Credential	:
Telephone Number	:	786-602-0100

Provider Enumeration Date	:	03/11/2019
Last Update Date	:	03/11/2019

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