Provider Demographics
NPI:1013474550
Name:CHARLES, SPENCER (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:
Last Name:CHARLES
Suffix:
Gender:M
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 FLORIDA CLUB CIR APT 2206
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-8722
Mailing Address - Country:US
Mailing Address - Phone:239-465-6001
Mailing Address - Fax:239-919-8049
Practice Address - Street 1:1820 FLORIDA CLUB CIR APT 2206
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-8722
Practice Address - Country:US
Practice Address - Phone:239-465-6001
Practice Address - Fax:239-919-8049
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy