Individual
DR. CONSTANCE M CHARLES-LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1414 59TH ST W, BRADENTON, FL 34209-4607
(941) 761-0663
(941) 761-3347
Mailing address
1414 59TH ST W, BRADENTON, FL 34209-4607
(941) 761-0663
(941) 761-3347
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME61745
FL
208000000X
Pediatrics Physician
Primary
ME61745
FL
Other
Enumeration date
06/19/2006
Last updated
05/08/2024
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