Healthcare Provider Details

I. General information

NPI: 1326038001
Provider Name (Legal Business Name): JAMES A HART PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13403 BOYETTE RD
RIVERVIEW FL
33569-8742
US

IV. Provider business mailing address

13403 BOYETTE RD
RIVERVIEW FL
33569-8742
US

V. Phone/Fax

Practice location:
  • Phone: 813-654-1775
  • Fax:
Mailing address:
  • Phone: 813-654-1775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9116982
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: