Organization
SHINING STARS PEDIATRIC EXTENDED CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NATALIE MARTINEZ (TITLE MANAGER)
(305) 458-8688
Entity
Organization
Contact information
Practice address
5201 RAVENSWOOD RD STE 110, FT LAUDERDALE, FL 33312-6004
(786) 496-0287
Mailing address
6840 SW 14TH ST, MIAMI, FL 33144-5531
(305) 458-8688
Taxonomy
Speciality
Code
Description
License number
State
261QM3000X
Medically Fragile Infants and Children Day Care
Primary
—
—
Other
Enumeration date
10/21/2020
Last updated
11/08/2022
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