Individual
CHARLES N WITTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4106 W LAKE MARY BLVD STE 215, LAKE MARY, FL 32746-3344
(407) 332-7700
(321) 275-0339
Mailing address
4106 W LAKE MARY BLVD STE 215, LAKE MARY, FL 32746-3344
(407) 332-7700
(321) 275-0339
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME0057403
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063246500
—
FL
01
—
10292
BCBS
FL
01
—
340003010
MDCR RAILROAD
FL
Enumeration date
02/22/2006
Last updated
03/17/2018
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