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Individual
MR. CHARLES B MADDIX
Active
Individual
MR. CHARLES B MADDIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN, MSN, PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
APRN9173113
FL
2084P0804X
Child & Adolescent Psychiatry Physician
APRN9173113
FL
2084P0805X
Geriatric Psychiatry Physician
APRN9173113
FL
261QH0100X
Health Service Clinic/Center
APRN9173113
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN9173113
FL
Other
Enumeration date
06/13/2012
Last updated
04/18/2022
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