Healthcare Provider Details

I. General information

NPI: 1174172951
Provider Name (Legal Business Name): MASSON CATERING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 04/21/2022
Certification Date: 04/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

496 E 9TH ST
HIALEAH FL
33010-4548
US

IV. Provider business mailing address

496 E 9TH ST
HIALEAH FL
33010-4548
US

V. Phone/Fax

Practice location:
  • Phone: 305-887-2243
  • Fax: 305-887-0280
Mailing address:
  • Phone: 305-887-2243
  • Fax: 305-887-0280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSE LUIS MARANTE
Title or Position: PRESIDENT
Credential:
Phone: 305-887-2243