| Shands Medical Group Of Starke | |
|
1550 S Water St Starke FL 32091-4511 | |
| (904) 368-2343 | |
| (352) 733-0069 |
| Full Name | Shands Medical Group Of Starke |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1550 S Water St, Starke, Florida |
| Authorized Official Name and Position | Paula Lalor (DIRECTOR/DELEGATED OFFICIAL) |
| Authorized Official Contact | 6159254565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shands Medical Group Of Starke 1550 S Water St Starke FL 32091-4511 Ph: (904) 368-2343 | Shands Medical Group Of Starke 1550 S Water St Starke FL 32091-4511 Ph: (904) 368-2343 |
| NPI Number | 1457448284 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 01/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457448284 | NPI | - | NPPES |
| 010007201 | Medicaid | FL | |
| CB2503 | Other | FL | MEDICARE RR |
| 010007202 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 4267 (Florida) | Primary |
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