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General NPI Number Information
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NPI Number | 1033598511
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Entity Type | Organization
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Legal Business Name | STAR CARE CASE MANAGEMENT SERVICES INC
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Dates
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Enumeration Date | 05/29/2015
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Last Update Date | 06/10/2015
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Provider Practice Location Address
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Address Line | 175 FONTAINEBLEAU BLVD STE 2M7
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City | MIAMI
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State | FL
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Zip | 33172-4511
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Country | US
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Telephone | 786-973-9372
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Fax |
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Provider Business Mailing Address
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Address Line | 175 FONTAINEBLEAU BLVD STE 2M7
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City | MIAMI
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State | FL
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Zip | 33172-4511
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Country | US
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Telephone | 786-973-9372
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | YENNESY GIL CARRENO
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Credential | B.S.
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Telephone | 786-973-9372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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