Individual
CHARLES THOMAS BROCATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
111 AVENUE E, APALACHICOLA, FL 32320-2041
(850) 653-4545
(850) 653-4949
Mailing address
111 AVENUE E, APALACHICOLA, FL 32320-2041
(850) 653-4545
(850) 653-4949
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT12314
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8914228900
—
FL
01
—
Y03S0
BCBS FL - CARRABELLE
FL
Enumeration date
07/31/2006
Last updated
05/03/2010
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