1457505372 NPI number — SUPER STAR STAFF COORDINATOR SERVICES, INC.

Table of content: DANNY GARCIA CARDENAS BC (NPI 1548098585)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457505372 NPI number — SUPER STAR STAFF COORDINATOR SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUPER STAR STAFF COORDINATOR SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457505372
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1490 W 49TH PL
Provider Second Line Business Mailing Address:
STE 445
Provider Business Mailing Address City Name:
HIALEAH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33012-3148
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-556-2888
Provider Business Mailing Address Fax Number:
305-556-0220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1490 W 49TH PL
Provider Second Line Business Practice Location Address:
STE 445
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33012-3148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-556-2888
Provider Business Practice Location Address Fax Number:
305-556-0220
Provider Enumeration Date:
11/05/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RUIZ
Authorized Official First Name:
MAYRA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
305-556-2888

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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