DORAN R STARK MD PA
Medical Practice at Florida National Dr, Lakeland, FL

License number
Florida ME50899
Category
Medical Practice
Type
Plastic Surgery
Owner
Name: DR. DORAN R STARK M.D., PA
Title: PROVIDER
Phone: (863) 647-2200
Address
Address
4429 Florida National Dr, Lakeland, FL 33813
National Provider ID: 1487888731
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DORAN R. STARK, M.D., PA

Lakeland, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Doing business as:
Doran R Stark MD PA
Registration:
Feb 8, 1999
Phone:
(863) 647-2200 (Phone)
Addresses:
4429 Florida National Dr, Lakeland, FL 33813 (Physical)
1351 Brighton Way, Lakeland, FL 33813 (Mailing)
State ID:
P99000012585
Business type:
Florida Profit Corporation
Manager, Office Managers:
Vicki Phillips (Surgical Assistant),Pam Williams (Registered Nurse),Doran Rm.d. Stark Secretary, President, Owner, Plastic Surgeon, Medical Doctor, Physician Assistant, inactive, 1351 Brighton Way, Lakeland, FL 33813 (Physical),...
Agent:
Doran Stark,1351 Brighton Way, Lakeland, FL 33813 (Physical)
EIN:
59-3556131

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