Provider Demographics
NPI:1275866147
Name:LOUIS M. STARACE, M.D P.A
Entity Type:Organization
Organization Name:LOUIS M. STARACE, M.D P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:STARACE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-845-7078
Mailing Address - Street 1:6231 PGA BLVD STE 104
Mailing Address - Street 2:SUITE#123
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-4033
Mailing Address - Country:US
Mailing Address - Phone:561-845-7078
Mailing Address - Fax:561-845-8030
Practice Address - Street 1:701 NORTHLAKE BLVD
Practice Address - Street 2:SUITE#208
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-5215
Practice Address - Country:US
Practice Address - Phone:561-845-7078
Practice Address - Fax:561-845-8030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98453207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty