Healthcare Provider Details

I. General information

NPI: 1487934261
Provider Name (Legal Business Name): KATHLEEN RIOPELLE STRUNK D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN M RIOPELLE

II. Dates (important events)

Enumeration Date: 08/24/2011
Last Update Date: 10/05/2022
Certification Date: 10/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 S KANNER HWY
STUART FL
34994-4801
US

IV. Provider business mailing address

3801 S KANNER HWY
STUART FL
34994-4801
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-5757
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number053954
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberUO2805
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19295
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: