Provider Demographics
NPI:1194996371
Name:STARLITE HOME HEALTH AGENCY, INC
Entity type:Organization
Organization Name:STARLITE HOME HEALTH AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABEHT
Authorized Official - Middle Name:BARBARA
Authorized Official - Last Name:MONTEAGUDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-588-7505
Mailing Address - Street 1:303 N KROME AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-6057
Mailing Address - Country:US
Mailing Address - Phone:305-242-1471
Mailing Address - Fax:305-242-1472
Practice Address - Street 1:303 N KROME AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6057
Practice Address - Country:US
Practice Address - Phone:305-242-1471
Practice Address - Fax:305-242-1472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993064251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health