Individual
DR. CHARLES NELSON BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 S PALM AVE, PALATKA, FL 32177-4143
(386) 328-7493
(386) 328-4137
Mailing address
301 S PALM AVE, PALATKA, FL 32177-4143
(386) 328-7493
(386) 328-4137
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
035737
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042618100
—
FL
01
—
7522348
AETNA
FL
Enumeration date
08/12/2005
Last updated
02/24/2010
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