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General NPI Number Information
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NPI Number | 1699667527
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Entity Type | Organization
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Legal Business Name | NQO STARSERVICES CORP
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 415 S TREBOL ST
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City | CLEWISTON
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State | FL
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Zip | 33440-8299
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Country | US
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Telephone | 645-216-8529
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Fax |
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Provider Business Mailing Address
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Address Line | 415 S TREBOL ST
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City | CLEWISTON
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State | FL
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Zip | 33440-8299
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Country | US
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Telephone | 645-216-8529
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CLAUDIA M CUEVAS LOU
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Credential | MD
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Telephone | 645-216-8529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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