Healthcare Provider Details

I. General information

NPI: 1144286212
Provider Name (Legal Business Name): DAVID J STROH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14534 OLD SAINT AUGUSTINE RD STE 3420
JACKSONVILLE FL
32258-2616
US

IV. Provider business mailing address

PO BOX 43667
JACKSONVILLE FL
32203-3667
US

V. Phone/Fax

Practice location:
  • Phone: 904-493-8001
  • Fax: 904-338-0852
Mailing address:
  • Phone: 904-720-0799
  • Fax: 904-493-8015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberOS8967
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberOS8967
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: