Provider Demographics
NPI:1053533174
Name:STRATTON, MICHAEL LEE (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LEE
Last Name:STRATTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 DORIS DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-1006
Mailing Address - Country:US
Mailing Address - Phone:863-646-0243
Mailing Address - Fax:800-878-6125
Practice Address - Street 1:203 DORIS DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-1006
Practice Address - Country:US
Practice Address - Phone:863-646-0243
Practice Address - Fax:800-878-6125
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9305111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000097100Medicaid
FL7072851OtherCIGNA PPO
AW904ZMedicare PIN