Provider Demographics
NPI:1891730156
Name:TEMPONE, CHARLA K (AP, LMT)
Entity Type:Individual
Prefix:
First Name:CHARLA
Middle Name:K
Last Name:TEMPONE
Suffix:
Gender:F
Credentials:AP, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 S MACDILL AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609
Mailing Address - Country:US
Mailing Address - Phone:813-873-7773
Mailing Address - Fax:813-873-7772
Practice Address - Street 1:503 S MACDILL AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609
Practice Address - Country:US
Practice Address - Phone:813-873-7773
Practice Address - Fax:813-873-7772
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP913171100000X
FLMA0012627225700000X
FLMA12627225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
C0666Medicare UPIN
C6210Medicare UPIN