Provider Demographics
NPI:1598805699
Name:WALTMAN, CHARLES H (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:H
Last Name:WALTMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5115 US HIGHWAY 27 N STE 100
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-1323
Mailing Address - Country:US
Mailing Address - Phone:863-385-2222
Mailing Address - Fax:863-382-8765
Practice Address - Street 1:5115 US HIGHWAY 27 N STE 100
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1323
Practice Address - Country:US
Practice Address - Phone:863-385-2222
Practice Address - Fax:863-382-8765
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105528363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDL617ZMedicare UPIN