Provider Demographics
NPI:1548332612
Name:JACHIMOWICZ, JAMES R (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:JACHIMOWICZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13904 N DALE MABRY HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2446
Mailing Address - Country:US
Mailing Address - Phone:352-596-4030
Mailing Address - Fax:352-596-1997
Practice Address - Street 1:14543 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-6065
Practice Address - Country:US
Practice Address - Phone:352-596-4030
Practice Address - Fax:352-596-1997
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2022-09-02
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Provider Licenses
StateLicense IDTaxonomies
FLME056102207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00008874OtherADVANTICA
FL0000000001300OtherOPTIMUM
FL010024284OtherRAILROAD MEDICARE
FL5670278OtherAETNA
FL06675OtherUNIVERSAL HEALTHCARE
FL038296500Medicaid
FL08413OtherBLUE CROSS BLUE SHIELD FLORIDA
FL08413OtherHORIZON
FL0050216OtherGHI
FL08413OtherHORIZON
FL5670278OtherAETNA