Healthcare Provider Details

I. General information

NPI: 1518693001
Provider Name (Legal Business Name): MORGAN STAR HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 VONDERBURG DR STE 102
BRANDON FL
33511-6047
US

IV. Provider business mailing address

510 VONDERBURG DR STE 102
BRANDON FL
33511-6047
US

V. Phone/Fax

Practice location:
  • Phone: 540-359-1948
  • Fax:
Mailing address:
  • Phone: 540-359-1948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: LILLIAN FERNANDEZ
Title or Position: OWNER
Credential:
Phone: 540-270-1790