Matthews, Charles Odell

Matthews, Charles Odell is an individual health care provider with primary practice located at 12909 N 56Th St Ste 203 , Tampa FL 33617-1274. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Matthews, Charles Odell can be contacted via phone (813) 985-0900.

Contact Information

Primary practice address
12909 N 56Th St Ste 203 Tampa FL 33617-1274
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY6713 Florida

Profile Details

NPI number 1356393714
LBN Legal business name Matthews, Charles Odell
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Mar 17th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356393714 NPPES
Florida Other 75019 BLUECROSS BLUESHIELD# -FL

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