Healthcare Provider Details

I. General information

NPI: 1033198965
Provider Name (Legal Business Name): JUSTIN STRITTMATTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 N BONITA AVE EMERGENCY DEPARTMENT
PANAMA CITY FL
32401-3623
US

IV. Provider business mailing address

PO BOX 9167
PANAMA CITY BEACH FL
32417-9167
US

V. Phone/Fax

Practice location:
  • Phone: 850-747-6000
  • Fax: 850-747-6323
Mailing address:
  • Phone: 850-665-3653
  • Fax: 850-665-3654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME0092292
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: