Healthcare Provider Details

I. General information

NPI: 1396332219
Provider Name (Legal Business Name): CUISINE BELLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2020
Last Update Date: 12/26/2020
Certification Date: 12/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US

IV. Provider business mailing address

7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US

V. Phone/Fax

Practice location:
  • Phone: 786-273-5700
  • Fax:
Mailing address:
  • Phone: 786-273-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MAX ALEXIS
Title or Position: CEO
Credential:
Phone: 783-273-5700