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General NPI Number Information
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NPI Number | 1851114383
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Entity Type | Organization
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Legal Business Name | COMIDAS ON THE GO
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 3215 NW 3RD ST
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City | MIAMI
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State | FL
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Zip | 33125-4901
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Country | US
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Telephone | 484-602-6811
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Fax |
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Provider Business Mailing Address
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Address Line | 3215 NW 3RD ST
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City | MIAMI
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State | FL
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Zip | 33125-4901
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Country | US
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Telephone | 484-602-6811
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRUNILDE COSTANTINO
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Credential |
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Telephone | 484-602-6811
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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 |
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License Number State |
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