# CHARLES L CARR JR DO PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649810540
- **Authorized official:** CHARLES L CARR JR. DO (PRESIDENT)
- **Authorized official phone:** (207) 332-0774

## Contact information

- **Practice address:** 4335 CHEVAL BLVD, LUTZ, FL 33558-5328
- **Practice address phone:** (207) 332-0774
- **Mailing address:** 3959 VAN DYKE RD \# 259, LUTZ, FL 33558-8025
- **Mailing address phone:** (207) 332-0774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | — | NULL | Yes |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/09/2020
- **Last updated:** 01/09/2020