Individual
CHARLES J. FAVELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 TRUMBO POINT, KEY WEST, FL 33040-6695
(305) 292-8883
Mailing address
100 TRUMBO POINT, KEY WEST, FL 33040-6695
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
FL
Other
Enumeration date
10/22/2007
Last updated
10/22/2007
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