Organization
SHINING STAR BEHAVIOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR FERNANDEZ (PRESIDENT)
(786) 543-5653
Entity
Organization
Contact information
Practice address
7921 BIRD RD STE 39, MIAMI, FL 33155-6747
(305) 539-0433
Mailing address
7921 BIRD RD STE 39, MIAMI, FL 33155-6747
(305) 539-0433
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/25/2020
Last updated
12/21/2022
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