Provider Demographics
NPI:1942478508
Name:JOSEPH J STRATER DC LLC
Entity Type:Organization
Organization Name:JOSEPH J STRATER DC LLC
Other - Org Name:STRATER FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATING MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:STRATER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:321-425-4620
Mailing Address - Street 1:1950 VIERA BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-6672
Mailing Address - Country:US
Mailing Address - Phone:321-425-4620
Mailing Address - Fax:321-425-4690
Practice Address - Street 1:1950 VIERA BLVD STE 106
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-6672
Practice Address - Country:US
Practice Address - Phone:321-425-4620
Practice Address - Fax:321-425-4690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9216111N00000X
FLCH9530111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3822931 00Medicaid