Healthcare Provider Details

I. General information

NPI: 1700397270
Provider Name (Legal Business Name): MIAMI NUTITION CATERING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2017
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 PALM AVE
HIALEAH FL
33010-4718
US

IV. Provider business mailing address

420 PALM AVE
HIALEAH FL
33010-4718
US

V. Phone/Fax

Practice location:
  • Phone: 786-553-8488
  • Fax: 786-513-6424
Mailing address:
  • Phone: 786-553-8488
  • Fax: 786-513-6424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174200000X
TaxonomyMeals Provider
License NumberCAT2329545
License Number StateFL

VIII. Authorized Official

Name: ALEJANDRO ABERTO SANTANA
Title or Position: PRESIDENT
Credential:
Phone: 786-553-8488