MEDICARE: LOUIS STARACE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	ME98453	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	200009519	OTHER	NY	RAILROAD MEDICARE #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5C3916	OTHER	NY	HEALTHNET #
2	RS365	OTHER	NY	OXFORD #
4	109715	OTHER	NY	WELLCARE #
5	0500258	OTHER	NY	GHI PPO #
6	0056369	OTHER	NY	AETNA HMO#
7	132670769	OTHER	NY	TAX ID#
8	362563	OTHER	NY	MVP #
9	156861	OTHER	NY	HIP #
10	4294790	OTHER	NY	AETNA PPO#
11	96D061	OTHER	NY	EMPIRE BCBS #

General Provider Information

NPI Number	:	1336219690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS STARACE M.D.

Provider Business Mailing Address
First Line	:	6231 PGA BLVD
Second Line	:	SUITE 104-123
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-4033
Country	:	US
Telephone Number	:	561-972-4645
Fax Number	:	561-972-4839

Provider Business Practice Location Address
First Line	:	6231 PGA BLVD
Second Line	:	SUITE 104-123
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-4033
Country	:	US
Telephone Number	:	561-972-4645
Fax Number	:	561-972-4839

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	06/16/2016

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Directions to “ LOUIS STARACE M.D.” Practice Location

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