Provider Demographics
NPI:1275868473
Name:STRANDBERG, MARY JANE (ARNP, NP-C)
Entity Type:Individual
Prefix:
First Name:MARY JANE
Middle Name:
Last Name:STRANDBERG
Suffix:
Gender:F
Credentials:ARNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12977 SOUTHERN BLVD BLDG 5
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-9255
Mailing Address - Country:US
Mailing Address - Phone:561-798-8184
Mailing Address - Fax:561-793-2588
Practice Address - Street 1:1025 MILITARY TRL
Practice Address - Street 2:209
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7040
Practice Address - Country:US
Practice Address - Phone:561-747-1987
Practice Address - Fax:561-747-1313
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9231865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily