Provider Demographics
NPI:1669418901
Name:IRWIN, JAMES M (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:IRWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16105 N FLORIDA AVE STE E
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-6161
Mailing Address - Country:US
Mailing Address - Phone:813-644-4572
Mailing Address - Fax:
Practice Address - Street 1:16105 N FLORIDA AVE STE E
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-6161
Practice Address - Country:US
Practice Address - Phone:813-644-4572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53519207R00000X, 207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL048976000Medicaid
FLP01468006OtherRAILROAD
FL05936UMedicare PIN
FLP01468006OtherRAILROAD