Provider Demographics
NPI:1033198965
Name:STRITTMATTER, JUSTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:STRITTMATTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9167
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32417-9167
Mailing Address - Country:US
Mailing Address - Phone:850-665-3653
Mailing Address - Fax:850-665-3654
Practice Address - Street 1:615 N BONITA AVE
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3623
Practice Address - Country:US
Practice Address - Phone:850-747-6000
Practice Address - Fax:850-747-6323
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0092292207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA254305183AMedicaid
FL52413OtherBCBS
FL271626700Medicaid
GA254305183AMedicaid
FLH85001Medicare UPIN
FL52413OtherBCBS
FL52413XMedicare PIN