Provider Demographics
NPI:1871069567
Name:CARNIVAL MEALS AND FOODS, LLC
Entity type:Organization
Organization Name:CARNIVAL MEALS AND FOODS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AYMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMEJO GODOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-998-9849
Mailing Address - Street 1:15941 MELLEN LN
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33478-6621
Mailing Address - Country:US
Mailing Address - Phone:305-998-9849
Mailing Address - Fax:786-364-1332
Practice Address - Street 1:15941 MELLEN LN
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33478-6621
Practice Address - Country:US
Practice Address - Phone:305-998-9849
Practice Address - Fax:786-364-1332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-19
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
No174200000XOther Service ProvidersMeals
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL693208800Medicaid