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General NPI Number Information
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NPI Number | 1306512074
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Entity Type | Organization
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Legal Business Name | 5 STAR HEALTH GROUP LLC
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Dates
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Enumeration Date | 08/21/2021
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 6355 NW 36TH ST STE 200
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-7050
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Country | US
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Telephone | 786-377-5250
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Fax | 786-699-1551
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Provider Business Mailing Address
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Address Line | 6355 NW 36TH ST STE 200
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-7050
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Country | US
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Telephone | 786-377-5250
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Fax | 786-699-1551
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Authorized Official
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Title or Position | CEO, ADMINISTRATOR
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Name | DARIEL MONTESINO DIAZ
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Credential |
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Telephone | 305-299-8484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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