Healthcare Provider Details

I. General information

NPI: 1124606835
Provider Name (Legal Business Name): MADELINE STRICK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2499 GLADES RD STE 105
BOCA RATON FL
33431-7260
US

IV. Provider business mailing address

3101 PORT ROYALE BLVD APT 222
FORT LAUDERDALE FL
33308-7839
US

V. Phone/Fax

Practice location:
  • Phone: 561-227-9629
  • Fax:
Mailing address:
  • Phone: 630-881-1475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9114049
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: