Organization
HEAVENLY FOODS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PASHUN DOBSON (OWNER)
(786) 426-2611
Entity
Organization
Contact information
Practice address
4040 SW 69TH AVE, MIRAMAR, FL 33023-6688
(786) 426-2611
(954) 404-7601
Mailing address
4040 SW 69TH AVE, MIRAMAR, FL 33023-6688
(786) 426-2611
(954) 404-7601
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
SEA1617838
FL
335G00000X
Medical Foods Supplier
SEA1617838
FL
Other
Enumeration date
01/15/2016
Last updated
01/15/2016
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