Provider Demographics
NPI:1376176917
Name:5 STAR MEDICAL CARE LLC
Entity Type:Organization
Organization Name:5 STAR MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIARATANO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:844-578-2791
Mailing Address - Street 1:542 SW MCCOMB AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-3811
Mailing Address - Country:US
Mailing Address - Phone:561-445-9937
Mailing Address - Fax:
Practice Address - Street 1:542 SW MCCOMB AVE
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-3811
Practice Address - Country:US
Practice Address - Phone:561-445-9937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-21
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty