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General NPI Number Information
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NPI Number | 1497895114
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Entity Type | Organization
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Legal Business Name | L. STARKS, MD PA
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/07/2007
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Provider Practice Location Address
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Address Line | 2407 N ROOSEVELT BLVD
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City | KEY WEST
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State | FL
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Zip | 33040-3837
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Country | US
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Telephone | 305-295-9322
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Fax | 305-295-9326
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Provider Business Mailing Address
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Address Line | 2407 N ROOSEVELT BLVD
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City | KEY WEST
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State | FL
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Zip | 33040-3837
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Country | US
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Telephone | 305-295-9322
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Fax | 305-295-9326
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAWANNA M STARKS
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Credential | M.D.
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Telephone | 305-295-9322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME89232
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License Number State | FL
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