Individual
CHARLES CAMPOSANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
325 CLYDE MORRIS BLVD, #340, ORMOND BEACH, FL 32174-8178
(386) 615-8971
Mailing address
325 CLYDE MORRIS BLVD, SUITE 340, ORMOND BEACH, FL 32174-8178
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9110117
FL
Other
Enumeration date
01/17/2017
Last updated
01/17/2017
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