Individual
DR. CHARLES ODELL MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
12909 N 56TH ST STE 203, TAMPA, FL 33617-1274
(813) 985-0900
Mailing address
12909 N 56TH ST STE 203, TAMPA, FL 33617-1274
(813) 985-0900
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY6713
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75019
BLUECROSS BLUESHIELD# -FL
FL
Enumeration date
05/16/2006
Last updated
03/17/2009
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