MEDICARE: NC CUBAN BUFFET

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332U00000X	Home Delivered Meals

General Provider Information

NPI Number	:	1003050584
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NC CUBAN BUFFET

Provider Business Mailing Address
First Line	:	2606 NW 21ST TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-7113
Country	:	US
Telephone Number	:	786-953-7012
Fax Number	:

Provider Business Practice Location Address
First Line	:	2606 NW 21ST TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-7113
Country	:	US
Telephone Number	:	786-953-7012
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARIA A QUINONES
Credential	:
Telephone Number	:	786-252-5457

Provider Enumeration Date	:	04/28/2009
Last Update Date	:	04/28/2009

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Directions to “NC CUBAN BUFFET ” Practice Location

Language	Start Address	Practice Location

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