Active NPI
Charles Lynn Dale, C.O.
- Orthotic Fitter
- Bay Pines, FL
National Provider Identifier
1699868299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotic Fitter
- License
- N/A
- Practice address
- 10000 Bay Pines Blvd
Prosthetic BLDG 23
Bay Pines, FL 33744-5005 - Phone
- (727) 398-6661
- Fax
- (727) 398-9538
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | N/A | FL | Primary |
Addresses
Primary practice location
10000 Bay Pines Blvd
Prosthetic BLDG 23
Bay Pines, FL 33744-5005
Mailing address
11140 105TH Avenue N.
Largo, FL 33778-4101
Phone (727) 397-5583
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N/A | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699868299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11140 105TH AVENUE N.",
"city": "LARGO",
"state": "FL",
"postal_code": "337784101",
"telephone_number": "727-397-5583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10000 BAY PINES BLVD",
"address_2": "PROSTHETIC BLDG 23",
"city": "BAY PINES",
"state": "FL",
"postal_code": "337445005",
"telephone_number": "727-398-6661",
"fax_number": "727-398-9538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALE",
"first_name": "CHARLES",
"middle_name": "LYNN",
"name_prefix": "Mr.",
"credential": "C.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": "FL",
"license": "N/A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bay Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.