Provider Demographics
NPI:1356844765
Name:STAT RN LLC
Entity Type:Organization
Organization Name:STAT RN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MYRLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-709-9793
Mailing Address - Street 1:50 EAST SAMPLE ROAD
Mailing Address - Street 2:SUITE 301/A
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-3549
Mailing Address - Country:US
Mailing Address - Phone:954-709-9793
Mailing Address - Fax:888-349-8679
Practice Address - Street 1:50 EAST SAMPLE ROAD
Practice Address - Street 2:SUITE 301/A
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-3549
Practice Address - Country:US
Practice Address - Phone:954-709-9793
Practice Address - Fax:888-349-8679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health