Individual
DR. CHARLES S LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7647 W GULF TO LAKE HWY, SUITE 6, CRYSTAL RIVER, FL 34429-7962
(352) 795-1718
(352) 795-7898
Mailing address
7647 W GULF TO LAKE HWY, SUITE 6, CRYSTAL RIVER, FL 34429-7962
(352) 795-1718
(352) 795-7898
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME0029731
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035298500
—
FL
01
—
42122
BCBSFL
FL
05
—
660075100
—
FL
Enumeration date
08/20/2006
Last updated
12/29/2014
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