Healthcare Provider Details

I. General information

NPI: 1851309504
Provider Name (Legal Business Name): DENVER CHARLES PRICE RPFT,CRT-NPS,RPFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2252 LAKE POINTE CIR
LEESBURG FL
34748-9580
US

IV. Provider business mailing address

2252 LAKE POINTE CIR
LEESBURG FL
34748-9580
US

V. Phone/Fax

Practice location:
  • Phone: 352-255-9878
  • Fax:
Mailing address:
  • Phone: 352-255-9878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278P1004X
TaxonomyPulmonary Diagnostics Certified Respiratory Therapist
License NumberTT0003330
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: