Individual
CHARLES CEVALLOS
Active
Individual
CHARLES CEVALLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
UO3899
FL
207RC0000X
Cardiovascular Disease Physician
Primary
OS16582
FL
390200000X
Student in an Organized Health Care Education/Training Program
UO3899
FL
Other
Enumeration date
02/01/2017
Last updated
06/01/2020
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