MEDICARE: DR. JULIETTE KIRSTIN GITTINGER DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS0007726	FL

General Provider Information

NPI Number	:	1144201245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIETTE KIRSTIN GITTINGER DO

Provider Business Mailing Address
First Line	:	3007 RIDGELINE BLVD
Second Line	:	SUITE B
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34688-9103
Country	:	US
Telephone Number	:	727-945-7122
Fax Number	:	727-945-7121

Provider Business Practice Location Address
First Line	:	3007 RIDGELINE BLVD
Second Line	:	SUITE B
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34688-9103
Country	:	US
Telephone Number	:	727-945-7122
Fax Number	:	727-945-7121

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	06/24/2010

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