Shining Stars Pediatric Extended Care, LLC

Primary specialty

Medically Fragile Infants and Children Day CareTaxonomy code 261QM3000X

Legal business name

SHINING STARS PEDIATRIC EXTENDED CARE, LLC

Practice address

5201 Ravenswood Rd Ste 110
Ft Lauderdale, FL 33312-6004

Phone

(786) 496-0287

NPI assigned

Oct 21, 2020

Last updated

Nov 8, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Natalie MartinezNPI 1487324166

Title

Title Manager

Phone

(305) 458-8688

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Natalie Katrina Martinez

  • Physical Therapy Assistant
  • Miami Lakes, FL
  • NPI 1487324166
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1326647363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6840 SW 14TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331445531",
            "telephone_number": "305-458-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 RAVENSWOOD RD STE 110",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333126004",
            "telephone_number": "786-496-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINING STARS PEDIATRIC EXTENDED CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-21",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_title_or_position": "TITLE MANAGER",
        "authorized_official_telephone_number": "305-458-8688",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM3000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medically Fragile Infants and Children Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oscar Robert Sherman, MD
• Olivia Sherriton
• Lori Halpern Sherwood, O.T.
• Ryan Alan Shields, MD
• Adam Shiesha, DO
• Julie Lynne Shinn, APRN
• Shino Bay Cosmetic Dermatology & Laser Institute LLC
• Abiola Aina Shitta-Bey, M.D.,
• Divya Ravali Shivapuja, MD
• Devina Gooljar Shiwlochan, MD

• Medically Fragile Infants and Children Day Care in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Medically Fragile Infants and Children Day Care in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.