MEDICARE: MR. JAMES R. PITTS PA-C

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	363A00000X	Physician Assistant	PA9115873	FL
2	363A00000X	Physician Assistant	545	CO

General Provider Information

NPI Number	:	1225099575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES R. PITTS PA-C

Provider Business Mailing Address
First Line	:	PO BOX 11396
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4004
Country	:	US
Telephone Number	:	877-848-1463
Fax Number	:	615-469-6677

Provider Business Practice Location Address
First Line	:	1111 12TH ST STE 207
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-3007
Country	:	US
Telephone Number	:	305-295-3477
Fax Number	:	305-295-3550

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

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	08/15/2024

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