Provider Demographics
NPI:1275837759
Name:GREATER MIAMI CATERERS, INC.
Entity Type:Organization
Organization Name:GREATER MIAMI CATERERS, INC.
Other - Org Name:MASTER HOST
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-633-4616
Mailing Address - Street 1:4001 NW 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-5103
Mailing Address - Country:US
Mailing Address - Phone:305-633-4616
Mailing Address - Fax:305-635-5202
Practice Address - Street 1:4001 NW 31ST AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5103
Practice Address - Country:US
Practice Address - Phone:305-633-4616
Practice Address - Fax:305-635-5202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL33200000X332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL683998300Medicaid