Provider Demographics
NPI:1932941283
Name:HATZIMOURATIDES, GEORGE JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JAMES
Last Name:HATZIMOURATIDES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 CENTURY MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2141
Mailing Address - Country:US
Mailing Address - Phone:321-567-4984
Mailing Address - Fax:
Practice Address - Street 1:850 CENTURY MEDICAL DR
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2141
Practice Address - Country:US
Practice Address - Phone:321-529-0813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-08
Last Update Date:2024-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14970111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor