Provider Demographics
NPI:1952512717
Name:GATZA, JULIE L (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:L
Last Name:GATZA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:L
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:205 N GARDEN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-4124
Mailing Address - Country:US
Mailing Address - Phone:727-449-2008
Mailing Address - Fax:
Practice Address - Street 1:1000 S FORT HARRISON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3906
Practice Address - Country:US
Practice Address - Phone:727-298-1133
Practice Address - Fax:727-298-1144
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8097111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHX854ZMedicare PIN