| Shaping Stars Llc | |
|
11296 Sw 17th Ct Miramar FL 33025-6601 | |
| (954) 559-3759 | |
| Not Available |
| Full Name | Shaping Stars Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 11296 Sw 17th Ct, Miramar, Florida |
| Authorized Official Name and Position | Andrea Olivares Vargas (BCBA/ OWNER) |
| Authorized Official Contact | 9545593759 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaping Stars Llc 11296 Sw 17th Ct Miramar FL 33025-6601 Ph: () - | Shaping Stars Llc 11296 Sw 17th Ct Miramar FL 33025-6601 Ph: (954) 559-3759 |
| NPI Number | 1639768997 |
|---|---|
| Provider Enumeration Date | 01/12/2021 |
| Last Update Date | 01/12/2021 |
| Certification Date | 01/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639768997 | NPI | - | NPPES |
| 1346882370 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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