Organization
STAR SPORTS MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIET MARIE DECAMPOS M.D. (PHYSICIAN)
(850) 479-3320
Entity
Organization
Contact information
Practice address
9400 UNIVERSITY PKWY, SUITE 309, PENSACOLA, FL 32514-5752
(850) 479-3320
(850) 479-8789
Mailing address
PO BOX 30010, PENSACOLA, FL 32503-1010
(850) 479-3320
(850) 479-8789
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253484300
—
FL
01
—
DG3210
MEDICARE RAILROAD
—
Enumeration date
08/30/2006
Last updated
12/20/2011
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