Provider Demographics
NPI:1467897991
Name:MBF CORP
Entity Type:Organization
Organization Name:MBF CORP
Other - Org Name:EATZGOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYRNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:NUTRITIONIST
Authorized Official - Phone:787-522-0540
Mailing Address - Street 1:B5 CALLE TABONUCO STE 211
Mailing Address - Street 2:GALERIA SAN PATRICIO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-3013
Mailing Address - Country:US
Mailing Address - Phone:787-522-0540
Mailing Address - Fax:787-522-0541
Practice Address - Street 1:B5 CALLE TABONUCO STE 211
Practice Address - Street 2:GALERIA SAN PATRICIO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-3013
Practice Address - Country:US
Practice Address - Phone:787-522-0540
Practice Address - Fax:787-522-0541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR629261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center