Organization
CHARLES DAVENPORT MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES DAVENPORT M.D. (MEDICAL DIRECTOR)
(941) 951-2100
Entity
Organization
Contact information
Practice address
1250 S TAMIAMI TRL, SUITE 103, SARASOTA, FL 34239-2221
(941) 951-2100
(941) 894-3123
Mailing address
1250 S TAMIAMI TRL, SUITE 103, SARASOTA, FL 34239-2221
(941) 951-2100
(941) 894-3123
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME60801
FL
Other
Enumeration date
02/18/2009
Last updated
02/18/2009
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