Provider Demographics
NPI:1669351656
Name:START PROFESSIONAL CARE & SUPPORT LLC
Entity type:Organization
Organization Name:START PROFESSIONAL CARE & SUPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARICHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-442-6465
Mailing Address - Street 1:11117 W OKEECHOBEE RD STE 130
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8359 BEACON BLVD STE 408
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3062
Practice Address - Country:US
Practice Address - Phone:305-396-8973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-02
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty