Provider Demographics
NPI:1053742015
Name:DOMINGA TROPICAL INC.
Entity type:Organization
Organization Name:DOMINGA TROPICAL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:U
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-405-7838
Mailing Address - Street 1:15100 NW 67TH AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2102
Mailing Address - Country:US
Mailing Address - Phone:305-405-7838
Mailing Address - Fax:
Practice Address - Street 1:15100 NW 67TH AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2102
Practice Address - Country:US
Practice Address - Phone:305-405-7838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSEA2331836332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals