Provider Demographics
NPI:1346795978
Name:STAR RELIEF CENTER
Entity Type:Organization
Organization Name:STAR RELIEF CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MALVYS
Authorized Official - Middle Name:C
Authorized Official - Last Name:DIAZ GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-505-7034
Mailing Address - Street 1:2750 SW 87TH AVE
Mailing Address - Street 2:SUITE #202
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2750 SW 87TH AVE
Practice Address - Street 2:SUITE #202
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3254
Practice Address - Country:US
Practice Address - Phone:305-505-7034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center