Healthcare Provider Details

I. General information

NPI: 1588607246
Provider Name (Legal Business Name): MORNING STAR CENTERS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7811 CORAL WAY SUITE# 106
MIAMI FL
33155-6540
US

IV. Provider business mailing address

7811 CORAL WAY SUITE# 106
MIAMI FL
33155-6540
US

V. Phone/Fax

Practice location:
  • Phone: 305-412-0138
  • Fax: 305-412-0140
Mailing address:
  • Phone: 305-412-0138
  • Fax: 305-412-0140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberHCC7040
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberHCC7040
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberHCC7040
License Number StateFL

VIII. Authorized Official

Name: MR. MIGUEL OLIVA
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 786-399-7710