Provider Demographics
NPI:1497895114
Name:L. STARKS, MD PA
Entity Type:Organization
Organization Name:L. STARKS, MD PA
Other - Org Name:STARKS PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:STARKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-295-9322
Mailing Address - Street 1:2407 N ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-3837
Mailing Address - Country:US
Mailing Address - Phone:305-295-9322
Mailing Address - Fax:305-295-9326
Practice Address - Street 1:2407 N ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3837
Practice Address - Country:US
Practice Address - Phone:305-295-9322
Practice Address - Fax:305-295-9326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89232208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty