Provider Demographics
NPI:1952501967
Name:5 STAR HOME CARE, LLC
Entity Type:Organization
Organization Name:5 STAR HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON
Authorized Official - Prefix:
Authorized Official - First Name:MARIANELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARVAJAL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:786-325-6219
Mailing Address - Street 1:15025 NW 77TH AVE
Mailing Address - Street 2:SUITE 121
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-6852
Mailing Address - Country:US
Mailing Address - Phone:786-338-9220
Mailing Address - Fax:786-338-9222
Practice Address - Street 1:15025 NW 77TH AVE
Practice Address - Street 2:SUITE 121
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-6854
Practice Address - Country:US
Practice Address - Phone:786-338-9220
Practice Address - Fax:786-338-9222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992821251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health