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NPI Code Detail

MEDICARE: R. G. STRATT MD, PA

MEDICARE: R. G. STRATT MD, PA
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
1207Q00000XFamily Medicine PhysicianME0074811FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11538130281OTHERFLNPI

General Provider Information

NPI Number : 1538130281
Entity Type Code : Individual
Provider Name (Legal Business Name) : R. G. STRATT MD, PA
Provider Business Mailing Address
First Line : 100 N FEDERAL HWY
Second Line : SUITE C-2
City : FT LAUDERDALE
State : FL
Zip : 33301-1129
Country : US
Telephone Number : 954-765-1316
Fax Number : 954-765-1461
Provider Business Practice Location Address
First Line : 100 N FEDERAL HWY
Second Line : SUITE C-2
City : FT LAUDERDALE
State : FL
Zip : 33301-1129
Country : US
Telephone Number : 954-765-1316
Fax Number : 954-765-1461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2006
Last Update Date : 03/28/2008

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