Provider Demographics
NPI:1366564403
Name:GITOMER, JOSHUA E (PT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:E
Last Name:GITOMER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11501 CARROLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-3711
Mailing Address - Country:US
Mailing Address - Phone:813-787-5454
Mailing Address - Fax:888-814-0038
Practice Address - Street 1:6516 GUNN HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-4022
Practice Address - Country:US
Practice Address - Phone:888-814-0038
Practice Address - Fax:888-814-0038
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21162225100000X
CO8800225100000X
WAPT00009840225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist