MEDICARE: LOUIS M. STARACE, M.D P.A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	ME98453	FL

General Provider Information

NPI Number	:	1275866147
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUIS M. STARACE, M.D P.A

Provider Business Mailing Address
First Line	:	6231 PGA BLVD STE 104
Second Line	:	SUITE#123
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-4033
Country	:	US
Telephone Number	:	561-845-7078
Fax Number	:	561-845-8030

Provider Business Practice Location Address
First Line	:	701 NORTHLAKE BLVD
Second Line	:	SUITE#208
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-5215
Country	:	US
Telephone Number	:	561-845-7078
Fax Number	:	561-845-8030

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	MR. LOUIS MARK STARACE
Credential	:	M.D.
Telephone Number	:	561-845-7078

Provider Enumeration Date	:	09/10/2009
Last Update Date	:	09/10/2009

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