Organization
BOCASA GOURMET, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZBET DOMINGUEZ VILA (OWNER)
(305) 519-3895
Entity
Organization
Contact information
Practice address
4709 SW 72ND AVE, MIAMI, FL 33155
(305) 519-3895
Mailing address
4709 SW 72ND AVE, MIAMI, FL 33155
(305) 519-3895
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015597700
—
FL
Enumeration date
07/22/2015
Last updated
01/30/2025
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