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General NPI Number Information
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NPI Number | 1689868622
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Entity Type | Individual
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Provider Name | CHARLES EUGENE POTTS MD
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Gender | Male
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 4450 W EAU GALLIE BLVD STE 250
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City | MELBOURNE
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State | FL
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Zip | 32934-7215
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Country | US
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Telephone | 321-751-6671
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Fax |
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Provider Business Mailing Address
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Address Line | 1975 SNAPDRAGON DR NW
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City | PALM BAY
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State | FL
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Zip | 32907-7207
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Country | US
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Telephone | 606-585-5448
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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 | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | ME128442
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License Number State | FL
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