Healthcare Provider Details

I. General information

NPI: 1598685349
Provider Name (Legal Business Name): THE FOOD TRUCK GANG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18135 CORALWOOD LN
GROVELAND FL
34736-9099
US

IV. Provider business mailing address

18135 CORALWOOD LN
GROVELAND FL
34736-9099
US

V. Phone/Fax

Practice location:
  • Phone: 407-921-3552
  • Fax:
Mailing address:
  • Phone: 407-921-3552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State

VIII. Authorized Official

Name: TONYA M SIMS
Title or Position: OWNER
Credential:
Phone: 407-921-3552