Provider Demographics
NPI:1982886297
Name:STAR LIGHT HEALTH CARE AGENCY INC
Entity Type:Organization
Organization Name:STAR LIGHT HEALTH CARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NAYELI
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-222-2240
Mailing Address - Street 1:11398 W FLAGLER ST
Mailing Address - Street 2:SUITE205
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-4213
Mailing Address - Country:US
Mailing Address - Phone:305-222-2240
Mailing Address - Fax:305-222-0223
Practice Address - Street 1:11398 W FLAGLER ST
Practice Address - Street 2:SUITE205
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-4213
Practice Address - Country:US
Practice Address - Phone:305-222-2240
Practice Address - Fax:305-222-0223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health