Provider Demographics
NPI:1235160805
Name:FITZ TROPICS MEDICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:FITZ TROPICS MEDICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLSTEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:727-844-5404
Mailing Address - Street 1:12464 INDIAN ROCKS RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3005
Mailing Address - Country:US
Mailing Address - Phone:727-596-1815
Mailing Address - Fax:727-593-0002
Practice Address - Street 1:12464 INDIAN ROCKS RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3005
Practice Address - Country:US
Practice Address - Phone:727-596-1815
Practice Address - Fax:727-593-0002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0007067207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2239Medicare ID - Type UnspecifiedGROUP'S NUMBER
FL57246ZMedicare PIN