Healthcare Provider Details

I. General information

NPI: 1871695569
Provider Name (Legal Business Name): STAR CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 BALLARD ST
ALTAMONTE SPRINGS FL
32701-5441
US

IV. Provider business mailing address

711 BALLARD ST
ALTAMONTE SPRINGS FL
32701-5441
US

V. Phone/Fax

Practice location:
  • Phone: 407-339-7451
  • Fax: 407-862-2737
Mailing address:
  • Phone: 407-339-7451
  • Fax: 407-862-2737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 2608
License Number StateFL

VIII. Authorized Official

Name: MR. JOHN FORD
Title or Position: OFFICE MANAGER
Credential:
Phone: 407-339-7451