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General NPI Number Information
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NPI Number | 1184463523
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Entity Type | Organization
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Legal Business Name | GANESH CHARI MD LLC
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Dates
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Enumeration Date | 05/24/2024
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 11375 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5409
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Country | US
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Telephone | 856-291-6138
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22253
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City | TAMPA
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State | FL
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Zip | 33622-2253
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Country | US
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Telephone | 727-823-2188
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Fax | 727-828-0723
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Authorized Official
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Title or Position | OWNER / PROVIDER
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Name | DR. GANESH CHARI
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Credential | MD
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Telephone | 856-291-6138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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