Provider Demographics
NPI:1003836719
Name:CHARLTON, RALPH WILLIAM (MD MAS)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:WILLIAM
Last Name:CHARLTON
Suffix:
Gender:M
Credentials:MD MAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1150 N 35TH AVE
Mailing Address - Street 2:SUITE 520
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5424
Mailing Address - Country:US
Mailing Address - Phone:954-265-6984
Mailing Address - Fax:954-981-5516
Practice Address - Street 1:1150 N 35TH AVE
Practice Address - Street 2:SUITE 520
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5424
Practice Address - Country:US
Practice Address - Phone:954-265-6984
Practice Address - Fax:954-981-5516
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1072892080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology