Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | ME95417 | FL |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | ME95417 | FL |
NPI | 1023058211 |
---|---|
Provider Name | Charles Cole Nofsinger |
First Address | Orlando, FL 32891-0001 |
Second Address | Tampa, FL 33612-6601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 09/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
275480100 | (05) | FL |
53060 | BLUE CROSS BLUE SHIELD (01) | FL |
H94545 | (02) |