Organization
THE BLUE TREE CAFE LIMITED LIABILITY CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON ALLEN MS. (OWNER)
(786) 239-9131
Entity
Organization
Contact information
Practice address
612 NW 9TH AVE STE A, FT LAUDERDALE, FL 33311-7674
(786) 239-9131
Mailing address
2701 TARPON DR, MIRAMAR, FL 33023-4524
(786) 239-9131
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
—
—
251300000X
Local Education Agency (LEA)
—
—
332U00000X
Home Delivered Meals
—
—
335G00000X
Medical Foods Supplier
—
—
Other
Enumeration date
10/17/2024
Last updated
10/17/2024
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