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NPI Code Detail

MEDICARE: CHARLES R READDY D.O.

MEDICARE: CHARLES R READDY D.O.
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
12085R0202XDiagnostic Radiology PhysicianOS7332FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982665055
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES R READDY D.O.
Provider Business Mailing Address
First Line : 1600 LAKELAND HILLS BLVD
Second Line :
City : LAKELAND
State : FL
Zip : 33805-3065
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 14055 RIVEREDGE DR STE 250
Second Line :
City : TAMPA
State : FL
Zip : 33637-2141
Country : US
Telephone Number : 813-396-6238
Fax Number : 813-929-5465
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2006
Last Update Date : 12/08/2025

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Directions to “ CHARLES R READDY D.O.” Practice Location

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