# MR. CHARLES B MADDIX

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1790047926
- **Gender:** Man
- **Credential:** APRN, MSN, PMHNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | APRN9173113 | FL | Yes |

## Other

- **Enumeration date:** 06/13/2012
- **Last updated:** 04/18/2022