Provider Demographics
NPI:1639787351
Name:STARLING, FREDRIC RUSSELL JR (RPH)
Entity Type:Individual
Prefix:DR
First Name:FREDRIC
Middle Name:RUSSELL
Last Name:STARLING
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 DEER FOREST DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-2010
Mailing Address - Country:US
Mailing Address - Phone:386-337-1883
Mailing Address - Fax:
Practice Address - Street 1:31201 US HIGHWAY 19 N STE 1
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-4422
Practice Address - Country:US
Practice Address - Phone:727-772-6868
Practice Address - Fax:727-772-6969
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL60634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist