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Individual

CHARLES R ANTHONY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
13063 CORTEZ BLVD, BROOKSVILLE, FL 34613-4838
(352) 597-0016
(352) 597-8699
Mailing address
PO BOX 1175, NEW PORT RICHEY, FL 34656-1175
(727) 841-8225
(727) 846-8549

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
0042079
FL
2085R0202X
Diagnostic Radiology Physician
Primary
0042079
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
069376600
FL
Enumeration date
05/24/2006
Last updated
10/12/2015
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