Charles Jacob Strader Jr., PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9108754 Issued in TN

Practice address

621 NW 53Rd St
Suite 330
Boca Raton, FL 33487

Phone

(800) 488-0279

Fax

(865) 560-8525

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prohealth Select, Inc.

  • Nurse Practitioner
  • Boca Raton, FL
  • NPI 1417485053

  Physician Assistant

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1891801171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11929 HEATHER WOODS CT",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34120",
            "telephone_number": "865-599-2163",
            "fax_number": "865-694-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 NW 53RD ST",
            "address_2": "SUITE 330",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33487",
            "telephone_number": "800-488-0279",
            "fax_number": "865-560-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRADER",
        "first_name": "CHARLES",
        "middle_name": "JACOB",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "PA9108754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Stokes
• Barry Stone, MD
• Josie Stone, MD
• Kathleen Stone, MS, RD, CDE
• Eileen S Storch, OTR
• Sara Taylor Stranieri, PA-C
• Bruce J Stratt, M.D.
• Abbey Strauss, MD
• Theodore Mitchell Strauss, DDS
• Yonette Ulana Streete, M.D.

• Surgical Physician Assistant in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.