Provider Demographics
NPI:1023084944
Name:STROHMEYER, JON FREDRIC (MD)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:FREDRIC
Last Name:STROHMEYER
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 1:702 GOODLETTE RD N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5628
Mailing Address - Country:US
Mailing Address - Phone:239-261-5525
Mailing Address - Fax:239-261-0933
Practice Address - Street 1:702 GOODLETTE RD N
Practice Address - Street 2:SUITE 100
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5628
Practice Address - Country:US
Practice Address - Phone:239-261-5525
Practice Address - Fax:239-261-0933
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0057826174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10812Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
FLE53973Medicare UPIN