Individual
DR. CHARLES E SANDERS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12662 TELECOM DR, TEMPLE TERRACE, FL 33637-0935
(813) 910-8708
(855) 852-7153
Mailing address
409 BAYSHORE BLVD, TAMPA, FL 33606-2707
(800) 844-9302
(813) 844-1655
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME62847
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18235X
MEDICARE PTAN
FL
05
—
371667800
—
FL
Enumeration date
05/23/2005
Last updated
04/25/2017
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