MEDICARE: HOME CARE 5 STAR SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker

General Provider Information

NPI Number	:	1538804067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME CARE 5 STAR SERVICES LLC

Provider Business Mailing Address
First Line	:	6733 SW 27TH CT
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-4801
Country	:	US
Telephone Number	:	786-234-3478
Fax Number	:

Provider Business Practice Location Address
First Line	:	6733 SW 27TH CT
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-4801
Country	:	US
Telephone Number	:	786-234-3478
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ADRIANA BODDEN
Credential	:
Telephone Number	:	786-234-3478

Provider Enumeration Date	:	04/29/2022
Last Update Date	:	04/29/2022

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Directions to “HOME CARE 5 STAR SERVICES LLC ” Practice Location

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