Individual
MR. CHARLES E. MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060
Mailing address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN9252142
FL
367500000X
Certified Registered Nurse Anesthetist
RN183244
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002157300
—
FL
01
—
554272
WELLCARE
GA
01
—
580628385
TRICARE
GA
01
—
593-04904
BLUE CROSS BLUE SHIELD
AL
05
—
988031166C
—
GA
01
—
G00C7
BLUE CROSS BLUE SHIELD
FL
01
—
P00857627
MEDICARE RAILROAD
—
Enumeration date
03/16/2009
Last updated
03/15/2023
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