| Charles Devine, M.d., P.a. | |
|
336 E Bloomingdale Ave Brandon FL 33511-8155 | |
| (813) 689-2466 | |
| (813) 689-0435 |
| Full Name | Charles Devine, M.d., P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 336 E Bloomingdale Ave, Brandon, Florida |
| Authorized Official Name and Position | Charles Devine (PRESIDENT) |
| Authorized Official Contact | 8136892466 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Devine, M.d., P.a. 336 E Bloomingdale Ave Brandon FL 33511-8155 Ph: (813) 689-2466 | Charles Devine, M.d., P.a. 336 E Bloomingdale Ave Brandon FL 33511-8155 Ph: (813) 689-2466 |
| NPI Number | 1982905717 |
|---|---|
| Provider Enumeration Date | 11/10/2010 |
| Last Update Date | 05/03/2011 |
| Medicare PECOS PAC ID | 7012192164 |
|---|---|
| Medicare Enrollment ID | O20110504000793 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982905717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME0072537 (Florida) | Primary |
| Provider Name | Charles D Devine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881687663 PECOS PAC ID: 8820273972 Enrollment ID: I20110504000808 |
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