Starke Family Medicine Clinic 01 INC

NPI #1760661938 in Starke, Florida

Provider Information

NPI Number: 1760661938
Entity Type: Organization
Organization Name: Starke Family Medicine Clinic 01 INC
Primary Specialty: Family Medicine
Enumeration Date: Oct 24, 2007
Last Updated: Oct 24, 2007

Practice Location

Address: 1546 S WATER ST
City: Starke
State: Florida
ZIP Code: 32091-4511
Phone: (904) 964-1888

Authorized Official

Name: NATALIA A SHIRIAEVA, MD
Title: PRESIDENT
Phone: (904) 964-1888

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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