Provider Demographics
NPI:1154352367
Name:PIZZA, JAMES T (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:T
Last Name:PIZZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 E FORT KING ST # 100
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-2558
Mailing Address - Country:US
Mailing Address - Phone:352-732-8404
Mailing Address - Fax:
Practice Address - Street 1:2441 E FORT KING ST # 100
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2558
Practice Address - Country:US
Practice Address - Phone:352-732-8404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81963207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC55711Medicare UPIN
FLE5790CMedicare PIN
FL264788500Medicaid