Healthcare Provider Details

I. General information

NPI: 1225951031
Provider Name (Legal Business Name): INFINITY STAR HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 JOCELYN DR APT 302 'ADMINISTRATIVE/TELEHEALTH USE ONLY'
FORT MILL SC
29708-0161
US

IV. Provider business mailing address

885 GOLD HILL RD # 1025
FORT MILL SC
29708-7946
US

V. Phone/Fax

Practice location:
  • Phone: 803-792-1174
  • Fax:
Mailing address:
  • Phone: 617-299-1271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. MARIE CRISTINE SENA
Title or Position: NURSE PRACTITIONER
Credential: APRN, FNP-C
Phone: 617-299-1271