Provider Demographics
NPI:1003583311
Name:STARNER, DARLENE FAITH (PT)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:FAITH
Last Name:STARNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 NE 9TH CT
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-2627
Mailing Address - Country:US
Mailing Address - Phone:239-898-0236
Mailing Address - Fax:
Practice Address - Street 1:3501 HANCOCK BRIDGE PKWY
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-7126
Practice Address - Country:US
Practice Address - Phone:239-217-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT12447225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist