Healthcare Provider Details

I. General information

NPI: 1114237286
Provider Name (Legal Business Name): LA AMERICA FOOD DELIVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3245 NW 7TH ST
MIAMI FL
33125-4139
US

IV. Provider business mailing address

3245 NW 7TH ST
MIAMI FL
33125-4139
US

V. Phone/Fax

Practice location:
  • Phone: 305-649-4343
  • Fax: 305-649-4344
Mailing address:
  • Phone: 305-649-4343
  • Fax: 305-649-4344

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: ALEJANDRO MEDINA
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 305-649-4343