Individual
CHARLES MCKINLEY ZOLLICOFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1871 SE TIFFANY AVE, SUITE 200, PORT ST LUCIE, FL 34952-7585
(772) 337-4000
(772) 335-4054
Mailing address
5827 CORPORATE WAY, WEST PALM BEACH, FL 33407-2000
(561) 844-9443
(561) 472-9692
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
231571
NY
207V00000X
Obstetrics & Gynecology Physician
Primary
ME 97653
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278332100
—
FL
01
—
ME97653
LICENSE
FL
Enumeration date
09/14/2006
Last updated
03/19/2019
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