Healthcare Provider Details

I. General information

NPI: 1285549634
Provider Name (Legal Business Name): MARMELYAAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11441 NW 40TH PL
SUNRISE FL
33323-1121
US

IV. Provider business mailing address

11441 NW 40TH PL
SUNRISE FL
33323-1121
US

V. Phone/Fax

Practice location:
  • Phone: 954-913-1051
  • Fax:
Mailing address:
  • Phone: 954-913-1051
  • 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: MARLENE HENDERSON
Title or Position: OWNER/MANAGING MEMBER
Credential:
Phone: 954-913-1051