MEDICARE: MR. CHARLES C DONLEY P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT-0004876	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588641211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES C DONLEY P.T.

Provider Business Mailing Address
First Line	:	1020 GODFREY AVE
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-6540
Country	:	US
Telephone Number	:	352-688-8066
Fax Number	:	352-688-8540

Provider Business Practice Location Address
First Line	:	465 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-5680
Country	:	US
Telephone Number	:	352-688-8066
Fax Number	:	352-688-8540

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	04/24/2026

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Directions to “ MR. CHARLES C DONLEY P.T.” Practice Location

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