Charles J Koller MD PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME63666 Issued in FL

Legal business name

CHARLES J KOLLER MD PA

Practice address

2055 Glenwood Dr
Winter Park, FL 32792-3307

Phone

(407) 645-3555

Fax

(407) 645-2555

NPI assigned

Sep 17, 2010

Last updated

Sep 17, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hilda Rodriguez

Title

Office Manager

Phone

(407) 645-3555

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Jay Koller, M.D.

  • Specialist
  • Winter Park, FL
  • NPI 1578571295
  Medicare reassignment Care Compare group NPD
• Courtney Thompson

  • Surgical Physician Assistant
  • Winter Park, FL
  • NPI 1942783642
  Medicare reassignment Care Compare group
• Quehuong H.T. Pham, M.D.

  • Surgery Physician
  • London, KY
  • NPI 1538137369

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284681600000",
    "number": "1689982183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 GLENWOOD DR",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923307",
            "telephone_number": "407-645-3555",
            "fax_number": "407-645-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 GLENWOOD DR",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923307",
            "telephone_number": "407-645-3555",
            "fax_number": "407-645-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES J KOLLER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-17",
        "last_updated": "2010-09-17",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "HILDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "407-645-3555"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME63666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charisms Care Specialists LLC
• Charles E. Williams, M.D.P.a.
• Charles English & Associates LLC (CEA Health Counseling)
• Charles English, PH.D. & Associates (Charles English, Ph.D. and Associates)
• Charles J Koller MD PA
• Charles Mella M.D. P.a.
• Anide Charles, MS
• Lee Ann Demza Charles, MD
• Karen Regina Charron, ARNP
• Kessem Chartor

• Surgery Physician in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.