Provider Demographics
NPI:1598548919
Name:STAR MEDICAL FL PLLC
Entity Type:Organization
Organization Name:STAR MEDICAL FL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, REVENUE CYCLE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-312-2295
Mailing Address - Street 1:7501 PARAGON RD STE 201
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-5323
Mailing Address - Country:US
Mailing Address - Phone:904-545-4465
Mailing Address - Fax:
Practice Address - Street 1:14964 MAX LEGGETT PKWY STE 106
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-7270
Practice Address - Country:US
Practice Address - Phone:904-686-1386
Practice Address - Fax:904-686-1363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty