Provider Demographics
NPI:1497999668
Name:MORNINGSTAR HOME HEALTH AGENCY,INC
Entity type:Organization
Organization Name:MORNINGSTAR HOME HEALTH AGENCY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TAIWO
Authorized Official - Middle Name:U
Authorized Official - Last Name:IMAFIDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-253-2714
Mailing Address - Street 1:160 NW 176TH ST
Mailing Address - Street 2:SUITE 302-6
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5021
Mailing Address - Country:US
Mailing Address - Phone:305-650-8664
Mailing Address - Fax:305-650-8653
Practice Address - Street 1:160 NW 176TH ST
Practice Address - Street 2:SUITE 302-6
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-5021
Practice Address - Country:US
Practice Address - Phone:305-650-8664
Practice Address - Fax:305-650-8653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993184251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health