Provider Demographics
NPI:1386640944
Name:STROHMAN, BARRY R (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:R
Last Name:STROHMAN
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 1:1107 LINWOOD LOOP
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-4238
Mailing Address - Country:US
Mailing Address - Phone:904-716-1278
Mailing Address - Fax:
Practice Address - Street 1:2736 UNIVERSITY BLVD WEST #3
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217
Practice Address - Country:US
Practice Address - Phone:904-292-8510
Practice Address - Fax:904-287-5616
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA1855363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS96430Medicare UPIN
FLE3495Medicare ID - Type Unspecified