MR. CHARLES JACOB STRADER JR.


Address: 621 Nw 53rd St, Suite 330, Boca Raton, FL 33487
Phone: 8004880279

MR. CHARLES JACOB STRADER JR. (NPI# 1891801171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1891801171
Entity Type Individual
Full Name MR. CHARLES JACOB STRADER JR.
Credential PAC
Practice Address 621 Nw 53rd St
Suite 330
Boca Raton
FL 33487
Mailing Address 11929 Heather Woods Ct
Naples
FL 34120
Practice Telephone 8004880279
Practice Fax Number 8655608525
Mailing Telephone 8655992163
Mailing Fax Number 8656947907
Enumeration Date 2006-08-21
Last Update Date 2019-09-19
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
PA9108754 TN Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 621 NW 53RD ST
SUITE 330
City BOCA RATON
State FL
Zip Code 33487

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NPI Name Taxonomy Address Enumeration
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1639237639 Julie Robin Asen Social Worker 621 Nw 53rd St, Suite 240, Boca Raton, FL 33487-8235 2006-12-04

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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1730665522 Prissy Graciela Rampaly Rangel Physician Assistant 23090 Post Gardens Way Apt 307, Boca Raton, FL 33433 2018-07-14
1891095196 Maria Fernanda Konieczko Physician Assistant 9135 Saddlecreek Dr, Boca Raton, FL 33496-1892 2010-11-02
1962529800 Kathleen A Duffy Physician Assistant 1211 Nw 15th St, Boca Raton, FL 33486-1204 2007-03-24
1861541096 Michele A. Mysnyk-deangelo Physician Assistant 951 Broken Sound Pkwy Ste 115, Boca Raton, FL 33487-3531 2007-01-09
1881762573 Craig Sprenger Physician Assistant 1398 Sw 18th St, Boca Raton, FL 33486-6634 2006-12-01
1134764830 Unidad De La Mujer LLC Physician Assistant 23090 Post Gardens Way Apt 307, Boca Raton, FL 33433-5666 2019-11-18
1881049302 Ashley Lelchuk Physician Assistant 670 Glades Rd, Suite #300, Boca Raton, FL 33431-6461 2016-05-03
1174992465 Matthew Earhart Physician Assistant 7301a W Palmetto Park Rd, #100b, Boca Raton, FL 33433-3409 2015-09-17
1578804183 Ronald Jay Kerble Physician Assistant 825 Meadows Rd, Suite #111, Boca Raton, FL 33486 2013-03-06
1952610461 Amy Miriam Forleiter Physician Assistant 670 Glades Rd Ste 220, Boca Raton, FL 33431-6464 2010-09-30
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Competitor

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City BOCA RATON
Zip Code 33487

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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