L. STARKS, MD PA
Medical Practice at Roosevelt Blvd, Key West, FL

License number
Florida ME89232
Category
Medical Practice
Type
Pediatrics
Owner
Name: DR. LAWANNA M STARKS M.D.
Title: OWNER
Phone: (305) 295-9322
Address
Address
2407 N Roosevelt Blvd, Key West, FL 33040
National Provider ID: 1497895114
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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L. STARKS, M.D., PA

Key West, FL

Status:
Inactive
Inactive reason:
Admin Dissolution For Annual Report
Registration:
Jul 8, 2004
Inactive since:
Sep 26, 2008
Addresses:
2407 N Roosevelt, Key West, FL 33040 (Physical)
2407 N Roosevelt Blvd, Key West, FL 33040
State ID:
P04000102300
Business type:
Florida Profit Corporation
Director:
Lawanna Starks Director, inactive, 10637 Claude Freeman Dr, Charlotte, NC 28262 (Physical)
Agent:
Donald Yates,611 Eaton St, Key West, FL 33040 (Physical)
EIN:
20-1501972

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