Provider Demographics
NPI:1548748163
Name:AMERICAN BLUE STAR
Entity Type:Organization
Organization Name:AMERICAN BLUE STAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-712-3321
Mailing Address - Street 1:8810 FONTAINEBLEAU BLVD APT 114
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4429
Mailing Address - Country:US
Mailing Address - Phone:786-712-3321
Mailing Address - Fax:
Practice Address - Street 1:8810 FONTAINEBLEAU BLVD APT 114
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4429
Practice Address - Country:US
Practice Address - Phone:786-712-3321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker