Provider Demographics
NPI:1467857953
Name:STAR KIDS LLC
Entity Type:Organization
Organization Name:STAR KIDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPANELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-399-6090
Mailing Address - Street 1:16320 S POST RD
Mailing Address - Street 2:APT 303
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3553
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16320 S POST RD
Practice Address - Street 2:APT 303
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3553
Practice Address - Country:US
Practice Address - Phone:786-399-6090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty