Healthcare Provider Details
I. General information
NPI: 1053230375
Provider Name (Legal Business Name): STARWELL MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7921 BIRD RD STE 39
MIAMI FL
33155-6747
US
IV. Provider business mailing address
20793 SW 129TH PL
MIAMI FL
33177-5528
US
V. Phone/Fax
- Phone: 305-842-8344
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SALYME
SAKER
Title or Position: PRESIDENT
Credential:
Phone: 305-842-8344