Individual
CHARLES R. SCHALLOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 UNIVERSITY BLVD, SUITE 200, JUPITER, FL 33458-2773
(561) 630-6939
(560) 630-9221
Mailing address
PO BOX 30308, PALM BEACH GARDENS, FL 33420-0308
(561) 630-6939
(561) 630-9221
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME59068
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055367100
—
FL
Enumeration date
12/12/2006
Last updated
11/08/2011
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