Healthcare Provider Details

I. General information

NPI: 1235009390
Provider Name (Legal Business Name): STAR MEDICAL FL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12715 PEGASUS DR
ORLANDO FL
32816-8030
US

IV. Provider business mailing address

110 COLLEGE ST STE E
ATHENS AL
35611-2714
US

V. Phone/Fax

Practice location:
  • Phone: 407-758-5735
  • Fax:
Mailing address:
  • Phone: 256-233-2393
  • Fax: 256-233-2309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: RACHEL MARIE ARNOLD
Title or Position: BILLING AND CREDENTIALING
Credential:
Phone: 256-321-1828