Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME24500 | FL |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME24500 | FL |
NPI | 1073583118 |
---|---|
Provider Name | Charles T Price |
First Address | Orlando, FL 32806-1215 |
Second Address | Orlando, FL 32806-1215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 07/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
057969600 | (05) | FL |
D55506 | (02) | FL |