Provider Demographics
NPI:1811202708
Name:STARLEEN SCHAFFER MDPA
Entity Type:Organization
Organization Name:STARLEEN SCHAFFER MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-388-4000
Mailing Address - Street 1:13000 US HIGHWAY 1
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3773
Mailing Address - Country:US
Mailing Address - Phone:772-388-4000
Mailing Address - Fax:772-388-4019
Practice Address - Street 1:13000 US HIGHWAY 1
Practice Address - Street 2:SUITE 4
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3773
Practice Address - Country:US
Practice Address - Phone:772-388-4000
Practice Address - Fax:772-388-4019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9600207Q00000X
FLME81334207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty