Healthcare Provider Details

I. General information

NPI: 1366756470
Provider Name (Legal Business Name): ONE STAR MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2010
Last Update Date: 02/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 W 29TH ST STE 5A
HIALEAH FL
33012-5736
US

IV. Provider business mailing address

50 W 29TH ST STE 5A
HIALEAH FL
33012-5736
US

V. Phone/Fax

Practice location:
  • Phone: 305-960-7678
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberHCC8933
License Number StateFL

VIII. Authorized Official

Name: MR. ABELARDO BARRETO
Title or Position: PRESIDENT
Credential:
Phone: 786-343-0148