Provider Demographics
NPI:1255988861
Name:KOHLER, CHARLES P (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:P
Last Name:KOHLER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 NW 110TH AVE APT 417
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-6967
Mailing Address - Country:US
Mailing Address - Phone:954-612-7141
Mailing Address - Fax:
Practice Address - Street 1:1405 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-7233
Practice Address - Country:US
Practice Address - Phone:954-784-3872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59544183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist