Provider Demographics
NPI:1942555248
Name:MAGSTAR CORNER LLC
Entity Type:Organization
Organization Name:MAGSTAR CORNER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARGALITTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCELIN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:954-224-7394
Mailing Address - Street 1:5038 SW 183RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-6317
Mailing Address - Country:US
Mailing Address - Phone:954-224-7394
Mailing Address - Fax:954-224-7395
Practice Address - Street 1:5038 SW 183RD AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-6317
Practice Address - Country:US
Practice Address - Phone:954-224-7394
Practice Address - Fax:954-224-7395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3314742163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty