Healthcare Provider Details

I. General information

NPI: 1255784666
Provider Name (Legal Business Name): MARCIA STARKMAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2016
Last Update Date: 07/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 THREE ISLANDS BLVD SUITE 1413
HALLANDALE BEACH FL
33009-2888
US

IV. Provider business mailing address

600 THREE ISLANDS BLVD. SUITE 1413
HALLANDALE BEACH FL
33009-2850
US

V. Phone/Fax

Practice location:
  • Phone: 305-979-8550
  • Fax:
Mailing address:
  • Phone: 305-979-8550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberCNS9301357
License Number StateFL

VIII. Authorized Official

Name: MS. MARCIA SUSAN STARKMAN
Title or Position: PSYCHIATRIC CLINICAL NURSE SPECIALI
Credential: RN MSN, PMHCNS-BC
Phone: 305-979-8550