Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | ME 0067838 | FL |
NPI | 1245200047 |
---|---|
Provider Name | Dr. Marlene J Starr |
First Address | Madeira Beach, FL 33708 |
Second Address | Madeira Beach, FL 33708-2670 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 03/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BJ 4406319 | DEA NUMBER (01) | FL |
ME 0067838 | FLORIDA MEDICAL LISCENSE (01) | FL |