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General NPI Number Information
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NPI Number | 1881279545
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Entity Type | Organization
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Legal Business Name | PADRINO'S RESATARUANT HALLANDALE, INC.
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Dates
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Enumeration Date | 03/15/2021
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 2500 E HALLANDALE BEACH BLVD
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-4834
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Country | US
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Telephone | 954-830-3034
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Fax |
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Provider Business Mailing Address
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Address Line | 10396 W STATE ROAD 84 STE 107
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City | DAVIE
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State | FL
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Zip | 33324-4258
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Country | US
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Telephone | 954-830-3034
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIO PADRINO
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Credential |
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Telephone | 954-328-9080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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