Healthcare Provider Details

I. General information

NPI: 1023720034
Provider Name (Legal Business Name): LITTLE HAVANA ACTIVITIES & NUTRITION CENTERS OF DADE COUNTY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2022
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 SW 8TH ST FL 33130
MIAMI FL
33130-3311
US

IV. Provider business mailing address

700 SW 8TH ST FL 33130
MIAMI FL
33130-3311
US

V. Phone/Fax

Practice location:
  • Phone: 305-858-0887
  • Fax:
Mailing address:
  • Phone: 305-858-0887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: MR. MANUEL JESUS FERNANDEZ
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 786-473-3000