Individual
CHARLES PROCUNIAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
5901 E FOWLER AVE STE 100, TEMPLE TERRACE, FL 33617-2305
(813) 978-9700
(813) 972-5055
Mailing address
5901 E FOWLER AVE STE 100, TEMPLE TERRACE, FL 33617-2305
(813) 978-9700
(813) 972-5055
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP1928122
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307537100
—
FL
Enumeration date
02/17/2006
Last updated
03/26/2025
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