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General NPI Number Information
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NPI Number | 1043326184
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Entity Type | Individual
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Provider Name | JAMES R TZIVANIS RPA
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 5915 W GULF TO LAKE HWY
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-7565
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Country | US
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Telephone | 352-794-3872
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Fax | 352-794-3876
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Provider Business Mailing Address
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Address Line | 5672 W JUSTIN CT
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City | HOMOSASSA
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State | FL
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Zip | 34448-1632
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Country | US
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Telephone | 352-628-7026
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 000469
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9104839
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License Number State | FL
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