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Organization

BEACHES BAR & CAFE

Active
Other names
Beaches Bars And Stand Alone Cafes, beaches bar and cafes
Organization subpart
No

Provider details

NPI number
Authorized official
MS. AYANNA BABCOCK SUTHERLAND PCT (CEO/FOUNDER)
(561) 294-5711
Entity
Organization

Contact information

Practice address
840 US HIGHWAY 1 STE 435C, N PALM BEACH, FL 33408-3829
(561) 294-7741
(561) 805-1097
Mailing address
4597 ARTHUR ST, PALM BEACH GARDENS, FL 33418-5733
(561) 294-7741
(561) 294-7741

Taxonomy

Speciality
Code
Description
License number
State
335G00000X
Medical Foods Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0108130000
FL
Enumeration date
05/17/2020
Last updated
12/17/2020
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