Organization
GUIDING LIGHT WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JODI STAR M.D. (MEDICAL DIRECTOR)
(561) 422-3314
Entity
Organization
Contact information
Practice address
3319 STATE ROAD 7, SUITE 210, WELLINGTON, FL 33449-8094
(561) 422-3314
(561) 422-3315
Mailing address
11924 W FOREST HILL BLVD, SUITE 22-300, WELLINGTON, FL 33414-6256
(561) 422-3314
(561) 422-3315
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME85603
FL
2084P0800X
Psychiatry Physician
Primary
ME85603
FL
2084P0804X
Child & Adolescent Psychiatry Physician
ME85603
FL
Other
Enumeration date
03/05/2007
Last updated
11/26/2010
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