Provider Demographics
NPI:1508430240
Name:STARKES, LISA YVETTE
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:YVETTE
Last Name:STARKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 SW COLLEGE ROAD, PMB NO.101
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474
Mailing Address - Country:US
Mailing Address - Phone:352-390-0161
Mailing Address - Fax:
Practice Address - Street 1:6135 NW 52ND STREET RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34482-2642
Practice Address - Country:US
Practice Address - Phone:352-390-0161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker