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General NPI Number Information
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NPI Number | 1699141473
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Entity Type | Organization
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Legal Business Name | CAFETERIA EMANUEL INC
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Dates
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Enumeration Date | 08/17/2015
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Last Update Date | 08/17/2015
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Provider Practice Location Address
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Address Line | 11480 QUAIL ROOST DR
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City | MIAMI
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State | FL
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Zip | 33157-6575
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Country | US
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Telephone | 786-342-4620
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Fax |
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Provider Business Mailing Address
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Address Line | 11480 QUAIL ROOST DR
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City | MIAMI
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State | FL
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Zip | 33157-6575
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Country | US
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Telephone | 786-342-4620
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. CARLOS MANUEL SUENGAS
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Credential |
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Telephone | 786-342-4620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number | NOS2328909
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License Number State | FL
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