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SHINING STARS PEDIATRIC EXTENDED CARE LLC NPI 1326647363


NPI Information

NPI: 1326647363
Provider Name: SHINING STARS PEDIATRIC EXTENDED CARE, LLC
Classification: Clinic/Center - 261QM3000X
Entity Type: Organization

Specialization: Medically Fragile Infants and Children Day Care

CLIA Number: 10D2237441

Address:
5201 RAVENSWOOD RD STE 110
FT LAUDERDALE, FL
ZIP 33312
Phone: (786) 496-0287
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SHINING STARS PEDIATRIC EXTENDED CARE, LLC is a medically fragile infants and children day care clinic center in Ft Lauderdale, FL. The provider is an entity, facility, or distinct part of a facility specially equipped and staffed to provide care for medically fragile children with varied and complex care needs (e.g., enteral or parental feeding, ostomy care, respiratory/ventilator care, medications and therapies, etc.). SHINING STARS PEDIATRIC EXTENDED CARE, LLC NPI is 1326647363. The provider is registered as an organization entity type.

The provider's business location address is:

5201 RAVENSWOOD RD STE 110
FT LAUDERDALE, FL
ZIP 33312-004
Phone: (786) 496-0287

The provider's authorized official is Natalie Martinez .
The authorized official title is Title Manager and has the following contact phone number (305) 458-8688.

The CLIA number assigned to this NPI record is 10D2237441 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/21/2020 and was last updated on 10/21/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM3000XClinic/CenterMedically Fragile Infants and Children Day CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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