Healthcare Provider Details

I. General information

NPI: 1407751654
Provider Name (Legal Business Name): ELITE CATERING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S NEW HAMPSHIRE AVE
TAVARES FL
32778-3818
US

IV. Provider business mailing address

PO BOX 1496
WINDERMERE FL
34786-1496
US

V. Phone/Fax

Practice location:
  • Phone: 407-879-6761
  • Fax:
Mailing address:
  • Phone: 407-879-6761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ALFRED MANN
Title or Position: OWNER
Credential:
Phone: 407-879-6761