Provider Demographics
NPI:1598711889
Name:PITARYS, CHRISTOS JAMES II (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOS
Middle Name:JAMES
Last Name:PITARYS
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14100 FIVAY ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-7159
Mailing Address - Country:US
Mailing Address - Phone:727-749-8771
Mailing Address - Fax:727-842-4962
Practice Address - Street 1:6633 FOREST AVE STE 203
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-2612
Practice Address - Country:US
Practice Address - Phone:727-849-8771
Practice Address - Fax:727-842-4962
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57340207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10443OtherBCBS
060063895OtherRAILROAD MEDICARE
FL057377900Medicaid
202415OtherAVMED
FL169440OtherWELLCARE
FL10443TMedicare PIN
FL169440OtherWELLCARE
FL10443OtherBCBS
FL10443CMedicare PIN