MEDICARE: 5 STAR CARES, INC

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	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679032379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	5 STAR CARES, INC

Provider Business Mailing Address
First Line	:	1101 RAY CHARLES BLVD UNIT 1505
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-3019
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 RAY CHARLES BLVD UNIT 1505
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-3019
Country	:	US
Telephone Number	:	813-458-7553
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WILLIAM HOLLAND
Credential	:
Telephone Number	:	813-458-7553

Provider Enumeration Date	:	03/13/2019
Last Update Date	:	02/04/2020

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Directions to “5 STAR CARES, INC ” Practice Location

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