Healthcare Provider Details

I. General information

NPI: 1427099563
Provider Name (Legal Business Name): DAVID JOHN STRUNK O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 N COURTENAY PKWY
MERRITT ISLAND FL
32953-3495
US

IV. Provider business mailing address

665 S APOLLO BLVD
MELBOURNE FL
32901-1485
US

V. Phone/Fax

Practice location:
  • Phone: 321-453-5700
  • Fax: 321-452-5370
Mailing address:
  • Phone: 321-984-3200
  • Fax: 321-984-0032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC 1371
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: