NPI Code Details Logo

NPI 1386520484

NPI 1386520484 : STAR LAB LLC : MIRAMAR, FL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1386520484
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    STAR LAB LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/13/2025
-----------------------------------------------------
    Last Update Date     |    08/13/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2713 SW 64TH AVE 
-----------------------------------------------------
    City                 |    MIRAMAR
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    33023-3933
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    352-656-1106
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2713 SW 64TH AVE 
-----------------------------------------------------
    City                 |    MIRAMAR
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    33023-3933
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    352-656-1106
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    DIRECTOR
-----------------------------------------------------
    Name                 |     FRANTZ  PAUL 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    352-656-1106
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    291U00000X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Medical Laboratory
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.