MEDICARE: JIA GATES

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	225100000X	Physical Therapist	41937	FL

General Provider Information

NPI Number	:	1174488209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIA GATES

Provider Business Mailing Address
First Line	:	409 S GOMEZ AVE APT 1
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4194
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	409 S GOMEZ AVE APT 1
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4194
Country	:	US
Telephone Number	:	959-200-2267
Fax Number	:

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

Provider Enumeration Date	:	12/20/2025
Last Update Date	:	12/22/2025

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Directions to “ JIA GATES ” Practice Location

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