Provider Demographics
NPI:1518125392
Name:STEINMANN, CHARLES MAURICE
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:MAURICE
Last Name:STEINMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:CHARLES
Other - Middle Name:MAURICE
Other - Last Name:STEINMANN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:1912 STATE ROAD 44
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-8345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1912 STATE ROAD 44
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-8345
Practice Address - Country:US
Practice Address - Phone:386-423-1070
Practice Address - Fax:386-423-0780
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 11937225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL34-1853567-026OtherTRICARE
FL8841560-46Medicaid
FLQV3OtherBLUE CROSS / BLUE SHIELD
FL8841560-46Medicaid