Provider Demographics
NPI:1992247894
Name:STAR INTERNAL MEDICINE AND ASSOCIATES INC
Entity type:Organization
Organization Name:STAR INTERNAL MEDICINE AND ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:STARR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-742-4484
Mailing Address - Street 1:8045 SPYGLASS HILL RD STE 105
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8567
Mailing Address - Country:US
Mailing Address - Phone:321-610-4960
Mailing Address - Fax:
Practice Address - Street 1:8045 SPYGLASS HILL RD STE 105
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8567
Practice Address - Country:US
Practice Address - Phone:321-610-4960
Practice Address - Fax:321-610-4362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-08
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDME124494207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty