Healthcare Provider Details

I. General information

NPI: 1437168598
Provider Name (Legal Business Name): BRUCE J STRATT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 05/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7035 BERACASA WAY SUITE 102
BOCA RATON FL
33433-3405
US

IV. Provider business mailing address

17553 MIDDLEBROOK WAY
BOCA RATON FL
33496-1021
US

V. Phone/Fax

Practice location:
  • Phone: 844-442-6678
  • Fax:
Mailing address:
  • Phone: 609-332-8315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberME86772
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME 86772
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: