Provider Demographics
NPI:1457389702
Name:STRONG, RONALD J (PA-C)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:J
Last Name:STRONG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 PELICAN PL
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-5022
Mailing Address - Country:US
Mailing Address - Phone:727-754-6186
Mailing Address - Fax:727-754-6137
Practice Address - Street 1:1125 PELICAN PL
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-5022
Practice Address - Country:US
Practice Address - Phone:727-754-6186
Practice Address - Fax:727-754-6137
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA1597363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL970009068OtherRR M'CARE
FL970018003OtherRR M'CARE
FL290162500Medicaid
FLE0965OtherBCBS FL
FL970004162OtherRR M'CARE
FL290162500Medicaid
FLE0965ZMedicare ID - Type UnspecifiedLINK TO M'CARE GRP 72180
FLE0965YMedicare ID - Type UnspecifiedLINK TO M'CARE GRP 21949