Individual
DR. CHARLES H BOORAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1922 UNIVERSITY BLVD S, CREDENTIALING DEPARTMENT, JACKSONVILLE, FL 32216-8933
(904) 721-7844
(904) 727-3597
Mailing address
PO BOX 45443, SALT LAKE CITY, UT 84145-0443
(904) 202-1032
(904) 376-4107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME 40719
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080025632
PALMETTO GBA - RAILROAD
GA
01
—
P00640149
RR MEDICARE
FL
Enumeration date
05/03/2006
Last updated
12/13/2018
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