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General NPI Number Information
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NPI Number | 1174567002
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Entity Type | Individual
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Provider Name | CHARLES L NEUSTEIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 03/07/2019
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Provider Practice Location Address
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Address Line | 29277 US 19 N
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City | CLEARWATER
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State | FL
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Zip | 33761-2102
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Country | US
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Telephone | 727-313-4764
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Fax |
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Provider Business Mailing Address
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Address Line | 7324 SOUTHWEST FWY STE 1550
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City | HOUSTON
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State | TX
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Zip | 77074-2053
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Country | US
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Telephone | 713-779-9800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME0025433
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License Number State | FL
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