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Individual

MR. CHARLIE MACK II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
EP

Contact information

Practice address
8900 PARK BLVD, SEMINOLE, FL 33777-4119
(727) 545-4545
(727) 548-1360
Mailing address
1745 S HIGHLAND AVE, CLEARWATER, FL 33756-1852
(727) 767-0955
(727) 587-0527

Taxonomy

Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
FL

Other

Enumeration date
11/15/2019
Last updated
11/15/2019
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