Healthcare Provider Details
I. General information
NPI: 1922071331
Provider Name (Legal Business Name): CHARLES EATON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/08/2006
Last Update Date: 08/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1850 FOREST HILL BLVD STE 201
WEST PALM BEACH FL
33406
US
IV. Provider business mailing address
1850 FOREST HILL BLVD STE 201
WEST PALM BEACH FL
33406-6060
US
V. Phone/Fax
- Phone: 561-429-8279
- Fax: 561-828-0494
- Phone: 561-429-8279
- Fax: 561-828-0494
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | ME0053188 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: