Healthcare Provider Details

I. General information

NPI: 1407855174
Provider Name (Legal Business Name): STARLEEN CELESTE SCHAFFER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 07/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13000 US HIGHWAY 1 SUITE 4
SEBASTIAN FL
32958-3773
US

IV. Provider business mailing address

13000 US HIGHWAY 1 SUITE 4
SEBASTIAN FL
32958-3773
US

V. Phone/Fax

Practice location:
  • Phone: 772-388-4000
  • Fax: 772-388-4019
Mailing address:
  • Phone: 772-388-4000
  • Fax: 772-388-4019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME81334
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: