Healthcare Provider Details

I. General information

NPI: 1346298288
Provider Name (Legal Business Name): JOHN CHARNAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 10/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD 11C
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

5424 NW 72ND ST
GAINESVILLE FL
32653-3956
US

V. Phone/Fax

Practice location:
  • Phone: 352-376-1611
  • Fax: 352-379-7434
Mailing address:
  • Phone: 352-367-4492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberME 92738
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: