Provider Demographics
NPI:1225004963
Name:HUANG, CHARLES S (DO)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:S
Last Name:HUANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6700 S FLORIDA AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3310
Mailing Address - Country:US
Mailing Address - Phone:863-940-4750
Mailing Address - Fax:888-755-4350
Practice Address - Street 1:6700 S FLORIDA AVE STE 3
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3310
Practice Address - Country:US
Practice Address - Phone:863-940-4750
Practice Address - Fax:888-755-4350
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS00071832081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1205243714Medicare PIN
FLG34811Medicare UPIN
FL51742Medicare ID - Type Unspecified