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Individual

STACEY JULIA STRUHAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4202 E FOWLER AVE, TAMPA, FL 33620-8000
(813) 974-2201
(813) 974-4325
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-4325

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND9288
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GWS55
BLUE CROSS BLUE SHIELD
FL
01
LY123
MEDICARE
FL
Enumeration date
10/15/2019
Last updated
12/13/2019
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