Provider Demographics
NPI:1295364222
Name:DAVID'S FOOD AND FUN, INC
Entity Type:Organization
Organization Name:DAVID'S FOOD AND FUN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAGLIERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-486-0147
Mailing Address - Street 1:2620 W 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-1504
Mailing Address - Country:US
Mailing Address - Phone:786-486-0147
Mailing Address - Fax:
Practice Address - Street 1:2620 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-1504
Practice Address - Country:US
Practice Address - Phone:786-486-0147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335G00000XSuppliersMedical Foods Supplier