Provider Demographics
NPI:1487870853
Name:LA STARZA, MARCO JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:MARCO
Middle Name:JOSEPH
Last Name:LA STARZA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5689
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32783-5689
Mailing Address - Country:US
Mailing Address - Phone:407-970-7513
Mailing Address - Fax:
Practice Address - Street 1:1027 PATHFINDER WAY
Practice Address - Street 2:SUITE 110 A
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3267
Practice Address - Country:US
Practice Address - Phone:407-970-7513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9013111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor