MEDICARE: DR. CHARLES ALLAN SOFFER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH6109	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295956530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES ALLAN SOFFER DC

Provider Business Mailing Address
First Line	:	3201 SE SANTA BARBARA PL
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-4169
Country	:	US
Telephone Number	:	239-542-8009
Fax Number	:

Provider Business Practice Location Address
First Line	:	1722 DEL PRADO BLVD S
Second Line	:	#4
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-5525
Country	:	US
Telephone Number	:	239-542-8009
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. CHARLES ALLAN SOFFER DC” Practice Location

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