Healthcare Provider Details

I. General information

NPI: 1437141199
Provider Name (Legal Business Name): CHARLES F NARDI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 03/20/2024
Certification Date: 03/18/2024
Deactivation Date: 03/21/2006
Reactivation Date: 04/12/2006

III. Provider practice location address

8990 NAVARRE PKWY
NAVARRE FL
32566-2216
US

IV. Provider business mailing address

1005 MAR WALT DR ADMINISTRATION
FORT WALTON BEACH FL
32547-6707
US

V. Phone/Fax

Practice location:
  • Phone: 508-396-0108
  • Fax: 850-939-4933
Mailing address:
  • Phone: 850-863-8131
  • Fax: 850-863-4152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME71880
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: