Provider Demographics
NPI:1801852272
Name:RONZO, JAMES J (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:RONZO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4211 W BOY SCOUT BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5724
Mailing Address - Country:US
Mailing Address - Phone:855-485-3262
Mailing Address - Fax:813-443-8255
Practice Address - Street 1:5301 AVION PARK DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1416
Practice Address - Country:US
Practice Address - Phone:855-485-3262
Practice Address - Fax:813-443-8255
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8220174400000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5089870001OtherDME REGION C MEDICARE NUMBER
FL58533OtherBLUE SHIELD PROV #
FLP00042682OtherRAILROAD MEDICARE
FL58533OtherBLUE SHIELD PROV #
FL5089870001Medicare NSC
FLP00042682OtherRAILROAD MEDICARE