Organization
STARS MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GOWTHAMAN PANDIAN (COO)
(813) 816-5124
Entity
Organization
Contact information
Practice address
17541 N DALE MABRY HWY, LUTZ, FL 33548-4521
(813) 964-1800
Mailing address
17541 N DALE MABRY HWY, LUTZ, FL 33548-4521
(813) 964-1800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
Update your record
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