Organization
CHARLES R HABELOW MD PA
Active
Other names
Bayside Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES R. HABELOW M.D. (OWNER/PHYSICIAN)
(863) 494-2293
Entity
Organization
Contact information
Practice address
301 N BREVARD AVE, SUITE B, ARCADIA, FL 34266-4501
(863) 494-2293
(863) 494-1520
Mailing address
PO BOX 510310, PUNTA GORDA, FL 33951-0310
(863) 494-2293
(863) 494-1520
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME49217
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046638701
—
FL
01
—
1508029349
NPI , TYPE II
FL
01
—
1881601946
NPI, TYPE I
FL
01
—
DN9810
RAILROAD MEDICARE B PTAN
FL
Enumeration date
07/02/2008
Last updated
10/22/2010
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