Provider Demographics
NPI:1306692819
Name:STRIDE ADVANTAGE LLC
Entity type:Organization
Organization Name:STRIDE ADVANTAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GERDI
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-420-1897
Mailing Address - Street 1:4443 GLENBROOK LN
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-1568
Mailing Address - Country:US
Mailing Address - Phone:813-214-5420
Mailing Address - Fax:813-441-7825
Practice Address - Street 1:2965 PEARSON JAMES PLACE
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559
Practice Address - Country:US
Practice Address - Phone:813-214-5420
Practice Address - Fax:813-441-7825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty