Healthcare Provider Details

I. General information

NPI: 1134232390
Provider Name (Legal Business Name): CHARLES J. MURPHY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3013 DEL PRADO BLVD S STE 8
CAPE CORAL FL
33904-7238
US

IV. Provider business mailing address

2169 LOCHMOOR CIR
N FORT MYERS FL
33903-4926
US

V. Phone/Fax

Practice location:
  • Phone: 239-542-9233
  • Fax: 239-542-7710
Mailing address:
  • Phone: 239-542-9233
  • Fax: 239-542-7710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberCH4625
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: