Individual
CHARLES PITLUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
301 NORTHWEST 82ND AVE, COLUMBIA OUTPATIENT SURGICAL SERVICES, PLANTATION, FL 33324
(954) 424-1766
(954) 370-1533
Mailing address
PO BOX 17347, PLANTATION, FL 33318-7347
(954) 370-1053
(954) 370-1533
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS5052
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80240
BCBS
—
Enumeration date
11/02/2006
Last updated
03/06/2008
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