Charles Dack MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME36598 Issued in FL

Legal business name

CHARLES DACK MD

Practice address

114 McDonald St
Lakeland, FL 33803-1179

Phone

(863) 293-3909

Fax

(863) 293-1909

NPI assigned

May 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles Dack, MDNPI 1447273826

Title

Owner

Phone

(863) 293-3909

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Dack, MD

  • Legal Medicine
  • Lakeland, FL
  • NPI 1447273826
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619187465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 MCDONALD ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338031179",
            "telephone_number": "863-293-3909",
            "fax_number": "863-293-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 MCDONALD ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338031179",
            "telephone_number": "863-293-3909",
            "fax_number": "863-293-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES DACK MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DACK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-293-3909",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME36598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darren P Chapman, M.D.
• Elizabeth Chapman, MS, RDN, LDN
• Gary J. Chappel, M.D.
• Courtney Chappell, MS, EDS, LMHC
• Charles D. Llano, D.D.S.
• Charles Vickers DC PA
• Paulene Charles-Malcolm, OTD
• Alica Charles
• Carl Charlestin, MD
• Charmaine Health Care LLC

• Specialist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.