MEDICARE: MS. HEIDI NELL STRATER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW5677	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z024T	OTHER	FL	BC/BS

General Provider Information

NPI Number	:	1083708234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HEIDI NELL STRATER LCSW

Provider Business Mailing Address
First Line	:	8373 VIA SERENA
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-2240
Country	:	US
Telephone Number	:	561-470-7119
Fax Number	:	561-487-6546

Provider Business Practice Location Address
First Line	:	8020 WEST ATLANTIC BLD # 1
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-9713
Country	:	US
Telephone Number	:	561-637-2472
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/08/2007

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