Organization
STARKE HMA LLC
Active
Other names
Shands Medical Group of Starke
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL)
(615) 925-4565
Entity
Organization
Contact information
Practice address
1550 S WATER ST, STARKE, FL 32091-4511
(904) 368-2343
(352) 733-0069
Mailing address
1550 S WATER ST, STARKE, FL 32091-4511
(904) 368-2343
(352) 733-0069
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
4267
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010007201
—
FL
05
—
010007202
—
FL
01
—
CB2503
MEDICARE RR
FL
Enumeration date
10/05/2006
Last updated
01/08/2018
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