Healthcare Provider Details

I. General information

NPI: 1053022822
Provider Name (Legal Business Name): MARA EAT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12422 SW 44TH CT
MIRAMAR FL
33027-6003
US

IV. Provider business mailing address

12422 SW 44TH CT
MIRAMAR FL
33027-6003
US

V. Phone/Fax

Practice location:
  • Phone: 305-215-0720
  • Fax:
Mailing address:
  • Phone: 305-215-0720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. MARIA MARCAYDA
Title or Position: OWNER
Credential:
Phone: 305-215-0720