Charles D. Bowers
Individual provider Active NPI Audiologist · Tavares, FL
NPI 1104063783 · NPPES record last updated Jul 20, 2009
Key facts
- NPI
- 1104063783
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- AY1567 (FL)
- Practice address
- 3210 Waterman Way
Tavares, FL 32778-5243 - Phone
- (352) 343-4499
- NPI assigned
- Jan 19, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AY1567 | FL | Yes |
Addresses
Primary practice location
3210 Waterman Way
Tavares, FL 32778-5243
Mailing address
3210 Waterman Way
Tavares, FL 32778-5243
Phone (352) 343-4499
Other providers in Tavares, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.