Provider Demographics
NPI:1326299777
Name:FINK, CHARLES N (LMT, NMT)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:N
Last Name:FINK
Suffix:
Gender:M
Credentials:LMT, NMT
Other - Prefix:
Other - First Name:CHUCK
Other - Middle Name:
Other - Last Name:FINK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT, NMT
Mailing Address - Street 1:8327 PORTULACA AVE
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-3321
Mailing Address - Country:US
Mailing Address - Phone:727-459-5382
Mailing Address - Fax:
Practice Address - Street 1:8327 PORTULACA AVE
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-3321
Practice Address - Country:US
Practice Address - Phone:727-459-5382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA54435172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist