Individual
PETR STAROSTIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD BOX 100275, GAINESVILLE, FL 32610-0001
(352) 273-7842
(352) 273-8172
Mailing address
1600 SW ARCHER RD BOX 100275, GAINESVILLE, FL 32610-0275
(352) 273-7842
(352) 273-8172
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
225348
NY
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
ME121219
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013022800
—
FL
05
—
02313702
—
NY
Enumeration date
11/09/2005
Last updated
11/22/2017
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