Provider Demographics
NPI:1265522361
Name:REED, CHARLES D (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:D
Last Name:REED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 SW MARTIN DOWNS BLVD
Mailing Address - Street 2:244
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-6046
Mailing Address - Country:US
Mailing Address - Phone:772-219-9123
Mailing Address - Fax:
Practice Address - Street 1:2740 SW MARTIN DOWNS BLVD
Practice Address - Street 2:244
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-6046
Practice Address - Country:US
Practice Address - Phone:772-219-9123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0069157207P00000X, 207R00000X, 208000000X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine