Provider Demographics
NPI:1346550720
Name:JAMES A CHRISTENSEN MD PA
Entity Type:Organization
Organization Name:JAMES A CHRISTENSEN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-877-8201
Mailing Address - Street 1:4600 NORTH HABANA AVENUE
Mailing Address - Street 2:SUITE 21
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614
Mailing Address - Country:US
Mailing Address - Phone:813-877-8201
Mailing Address - Fax:813-875-3171
Practice Address - Street 1:4600 NORTH HABANA AVENUE
Practice Address - Street 2:SUITE 21
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614
Practice Address - Country:US
Practice Address - Phone:813-877-8201
Practice Address - Fax:813-875-3171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0014978208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL71493Medicare PIN
FLD65547Medicare UPIN