Individual
STEPHEN H STARK
Active
Individual
STEPHEN H STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
ME30869
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME30869
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056651900
—
FL
01
—
10721764
CAQH
FL
01
—
2569084
CIGNA
FL
01
—
269859500
MEDICAID GROUP
FL
01
—
30064
BCBS
FL
01
—
77940
MEDICARE GROUP ID
FL
01
—
77940
BCBS GRP
—
01
—
CF1416
MEDICARE RR GROUP
FL
01
—
ME30869
STATE LICENSE NUMBER
FL
01
—
P00144401
MEDICARE RR
FL
Enumeration date
12/01/2005
Last updated
10/09/2009
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