Provider Demographics
NPI:1518911643
Name:ALL STAR PEDIATRICS, INC.
Entity Type:Organization
Organization Name:ALL STAR PEDIATRICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:KARGES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-525-7852
Mailing Address - Street 1:4995 49TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-5901
Mailing Address - Country:US
Mailing Address - Phone:727-525-7852
Mailing Address - Fax:
Practice Address - Street 1:4995 49TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-5901
Practice Address - Country:US
Practice Address - Phone:727-525-7852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty