Healthcare Provider Details

I. General information

NPI: 1447214366
Provider Name (Legal Business Name): STAR MEDICAL EQUIPMENT RENTAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7750 W 26TH AVE UNIT 11
HIALEAH FL
33016-5698
US

IV. Provider business mailing address

7750 W 26TH AVE UNIT 11
HIALEAH FL
33016-5698
US

V. Phone/Fax

Practice location:
  • Phone: 305-887-7780
  • Fax: 305-887-0887
Mailing address:
  • Phone: 305-887-7780
  • Fax: 305-887-0887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number123
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number123
License Number StateFL

VIII. Authorized Official

Name: ESTEBAN RENE HERNANDEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-887-7780