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General NPI Number Information
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NPI Number | 1205375193
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Entity Type | Organization
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Legal Business Name | STELLAR ALF LLC
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Dates
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Enumeration Date | 02/13/2017
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Last Update Date | 08/01/2022
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Provider Practice Location Address
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Address Line | 14502 ROSEWOOD RD
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2656
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Country | US
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Telephone | 305-822-5248
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Fax | 786-219-4049
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Provider Business Mailing Address
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Address Line | 14502 ROSEWOOD RD
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2656
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Country | US
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Telephone | 305-822-5248
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Fax | 786-219-4049
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Authorized Official
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Title or Position | OWNER
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Name | ZAILYS OBREGON PINO
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Credential |
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Telephone | 786-312-4796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | FL
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