Organization
DJRJ2
Active
Other names
Comprehensive Women's Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH MICHAEL CHARL3S JR. MD (OWNER)
(386) 365-3845
Entity
Organization
Contact information
Practice address
4225 NW AMERICAN LN, LAKE CITY, FL 32055-8841
(386) 365-3845
Mailing address
PO BOX 805, LAKE CITY, FL 32056-0805
(386) 755-9190
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME82558
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274840100
—
FL
Enumeration date
11/10/2008
Last updated
11/10/2008
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