Provider Demographics
NPI:1972893568
Name:GATZA, JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:GATZA
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 1:1000 S FORT HARRISON AVE
Mailing Address - Street 2:SUTE A
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3906
Mailing Address - Country:US
Mailing Address - Phone:727-449-2008
Mailing Address - Fax:727-449-1499
Practice Address - Street 1:1000 S FORT HARRISON AVE
Practice Address - Street 2:STE. A
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3906
Practice Address - Country:US
Practice Address - Phone:727-449-2008
Practice Address - Fax:727-449-1499
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-15
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10275111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHX483ZMedicare PIN