Provider Demographics
NPI:1740288513
Name:STRUBBE, JAMES MARSHALL (DC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MARSHALL
Last Name:STRUBBE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:MARSHALL
Other - Last Name:STRUBBE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:5687 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3330
Mailing Address - Country:US
Mailing Address - Phone:727-541-6800
Mailing Address - Fax:727-544-4148
Practice Address - Street 1:5687 PARK BLVD
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3330
Practice Address - Country:US
Practice Address - Phone:727-541-6800
Practice Address - Fax:727-544-4148
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005663111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL051049100Medicaid
T83202Medicare UPIN
FL051049100Medicaid