Healthcare Provider Details
I. General information
NPI: 1174154801
Provider Name (Legal Business Name): MORNING STAR CENTERS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/31/2020
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7811 CORAL WAY STE 106
MIAMI FL
33155-6540
US
IV. Provider business mailing address
7811 CORAL WAY STE 106
MIAMI FL
33155-6540
US
V. Phone/Fax
- Phone: 305-412-0138
- Fax: 305-406-4506
- Phone: 305-412-0138
- Fax: 305-412-0140
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 | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MIGUEL
A
OLIVA
Title or Position: PRESIDENT
Credential:
Phone: 305-412-0138