Individual
CHARLES MARK HOMRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
710 LOMAX ST, JACKSONVILLE, FL 32204-4004
(904) 355-6583
(904) 355-4922
Mailing address
710 LOMAX ST, JACKSONVILLE, FL 32204-4004
(904) 355-6583
(904) 355-4922
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME72122
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251501600
—
FL
Enumeration date
02/12/2007
Last updated
05/08/2008
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