Provider Demographics
NPI:1811946635
Name:DARSTEK, TULAY (MD)
Entity type:Individual
Prefix:
First Name:TULAY
Middle Name:
Last Name:DARSTEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11181 HEALTH PARK BLVD
Mailing Address - Street 2:SUITE 2260
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-5738
Mailing Address - Country:US
Mailing Address - Phone:239-514-5006
Mailing Address - Fax:
Practice Address - Street 1:11181 HEALTH PARK BLVD
Practice Address - Street 2:SUITE 2260
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-5738
Practice Address - Country:US
Practice Address - Phone:239-514-5006
Practice Address - Fax:239-514-5008
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95721207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40916OtherBLUE CROSS BLUE SHIELD
FL40916OtherBLUE CROSS BLUE SHIELD
NJBE7795668OtherDEA