Male or Other

Mr. Charles L. Cornett PA-C

Medical Physician Assistant in Sanford, FL(View on Map)

Full Name

Mr. Charles L Cornett PA-C

NPI Number

1831191667

NPI Type

Individual Provider

Gender

Male

Enumeration Date

08/11/2005

Specialties

(Taxonomies)

Code

363AM0700X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

PA2490

Contact
Information

Purpose

Mailing
Location

Address

266 BRASSINGTON DR
2400 STATE ROAD 415

City

Debary
Sanford

State

FL
FL

Postal Code

32713-2139
32771

Country

US
US

Telephone Number

(386) 775-4063
(407) 322-8645

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

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