KENNETH E STARK MD PA NPI 1295916476

NPI Information

  • NPI: 1295916476
  • Provider Name: KENNETH E STARK MD PA
  • Classification: Internal Medicine - 207RR0500X
  • Specialization: Rheumatology
  • Entity Type: Organization
  • Address: 1613 BANNING BEACH RD
    TAVARES, FL
    ZIP 32778
  • Phone: (352) 343-7735

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NPI Details

KENNETH E STARK MD PA is a rheumatology internal medicine in Tavares, FL. The provider is an internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases. KENNETH E STARK MD PA NPI is 1295916476. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1613 BANNING BEACH RD
TAVARES, FL
ZIP 32778-024
Phone: (352) 343-7735
Fax: (352) 343-7740

The provider's authorized official is Kenneth E Stark .
The authorized official title is Physician and has the following contact phone number (352) 343-7735.

The enumeration date for this NPI number is 11/16/2007 and was last updated on 11/16/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RR0500XInternal MedicineRheumatologyME0045588FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1370164600MEDICAIDFLORIDA
209127OTHERFLORIDABCBS OF FLORIDA
36515425OTHERFLORIDACIGNA
4K7128MEDICARE PINFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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