Individual
CHARLES POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
545 HEALTH BLVD, DAYTONA BEACH, FL 32114-1493
(386) 239-8500
Mailing address
12109 COUNTY ROAD 103, OXFORD, FL 34484-2951
(352) 205-8981
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/09/2015
Last updated
04/08/2021
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