Provider Demographics
NPI:1407679731
Name:STAR LIFE CARE
Entity type:Organization
Organization Name:STAR LIFE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:MOLIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-316-5747
Mailing Address - Street 1:3445 SW 62ND WAY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5076
Mailing Address - Country:US
Mailing Address - Phone:305-316-5747
Mailing Address - Fax:
Practice Address - Street 1:3445 SW 62ND WAY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-5076
Practice Address - Country:US
Practice Address - Phone:305-316-5747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care