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General NPI Number Information
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NPI Number | 1609320837
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Entity Type | Organization
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Legal Business Name | STARUS PEDIATRICS LLC
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Dates
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Enumeration Date | 08/04/2016
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Last Update Date | 08/04/2016
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Provider Practice Location Address
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Address Line | 6001 VINELAND RD STE 103
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City | ORLANDO
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State | FL
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Zip | 32819-7829
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Country | US
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Telephone | 407-483-8814
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Fax | 407-978-6507
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Provider Business Mailing Address
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Address Line | 6001 VINELAND RD STE 103
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City | ORLANDO
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State | FL
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Zip | 32819-7829
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Country | US
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Telephone | 407-483-8814
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Fax | 407-978-6507
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDEL VALDES
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Credential | MD
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Telephone | 407-483-8814
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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 | ACN437
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License Number State | FL
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