CHARLES DACK (NPI# 1447273826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447273826 |
| Entity Type | Individual |
| Full Name | CHARLES DACK |
| Credential | MD |
| Practice Address |
114 Mcdonald St Lakeland FL 33803-1179 |
| Practice Telephone | 8632933909 |
| Practice Fax Number | 8632931909 |
| Mailing Telephone | 8632933909 |
| Mailing Fax Number | 8632931909 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 173000000X | Legal Medicine | ME36598 | FL | Other Service Providers |
| Street Address |
114 MCDONALD ST |
| City | LAKELAND |
| State | FL |
| Zip Code | 33803-1179 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619187465 | Charles Dack Md | Specialist | 114 Mcdonald St, Lakeland, FL 33803-1179 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861964819 | Steven P Agelidis | Counselor | 2020 S. Florida Ave, Suite 207, Lakeland, FL 33803 | 2018-12-31 |
| 1902316201 | Kesara Mai Ngam | Massage Therapist | 117 West Oak Drive, Lakeland, FL 33803 | 2017-10-02 |
| 1396260618 | Suncoast Behavioral Solutions, LLC | Behavioral Analyst | 1920 E Edgewood Dr Apt A8, Lakeland, FL 33803 | 2017-08-08 |
| 1316484413 | Daniel Jacob Stahl | Behavior Technician | 145 East Edgewood Drive, Lakeland, FL 33803 | 2017-01-26 |
| 1780037002 | Shelley Stettinius | Behavioral Analyst | 145 East Edgewood Dr, Lakeland, FL 33803 | 2016-07-21 |
| 1396106654 | Highlands Occupational Therapy, Inc | Occupational Therapist | 2000 East Edgewood Drive, Suite 114, Lakeland, FL 33803 | 2016-03-15 |
| 1003289570 | Jayna Dinsmore | Physical Therapy Assistant | 321 Imperial Blvd, D38, Lakeland, FL 33803 | 2015-11-05 |
| 1093187429 | Healthstat Wellness Polk-lakeland | Preventive Medicine | 3215 Winter Lake Road, Lakeland, FL 33803 | 2015-10-26 |
| 1962812545 | Florida Presbyterian Homes, Inc | Nursing Facility/Intermediate Care Facility | 901 Lakeside Avenue, Lakeland, FL 33803 | 2014-05-05 |
| 1710316336 | Trinity Endodontics | Health Maintenance Organization | 1602 S. Florida Ave, Ste #1, Lakeland, FL 33803 | 2013-11-04 |
| Find all providers in zip 33803 | ||||
| Taxonomy Code | 173000000X |
| Grouping | Other Service Providers |
| Classification | Legal Medicine |
| The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437369287 | J Roger Demonsthenes | Legal Medicine | 317 W 5th St, Lakeland, FL 33805-4446 | 2007-05-23 |
| 1710165469 | Sergio H. Vallejo M. D., P. A. | Legal Medicine | 1543 Lakeland Hills Blvd, Lakeland, FL 33805-3246 | 2008-02-05 |
| 1578610416 | Thomas K. Mcclane | Legal Medicine | 107 Morningside Dr Ste C, Lakeland, FL 33803-2600 | 2007-01-04 |
| 1780621607 | Primary Medical Center of Lakeland, LLC | Legal Medicine | 1417 Lakeland Hills Blvd, Suite #106, Lakeland, FL 33805-3200 | 2006-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679074561 | Joy Harris | Legal Medicine | 1950 Se Port St Lucie Blvd Ste 217, Port St Lucie, FL 34952-5579 | 2018-02-26 |
| 1386016137 | International Spine Center | Legal Medicine | 1310 Gulf Blvd Apt 2g, Clearwater, FL 33767-2859 | 2015-10-20 |
| 1639579923 | Duclos Dessalines | Legal Medicine | 4519 Lake Worth Rd, Greenacres, FL 33463-3449 | 2014-08-25 |
| 1679908867 | New Smyrna Pain & Injury Clinic | Legal Medicine | 421 N Causeway, New Smyrna Beach, FL 32169-5266 | 2013-09-06 |
| 1568710853 | Fmb Medical LLC | Legal Medicine | 7205 Estero Blvd Ste 733, Fort Myers Beach, FL 33931-4779 | 2012-08-17 |
| 1699047159 | Lazaro A Cabrera | Legal Medicine | 5575 Sw 77th Ct Apt 204b, Miami, FL 33155-4318 | 2012-01-30 |
| 1891074084 | Wellmed Medical Center | Legal Medicine | 9621 Bird Rd, Miami, FL 33165-4030 | 2011-08-05 |
| 1528377603 | William M. Escoffery | Legal Medicine | 300 Harbor Blvd Ste C, N/a, Destin, FL 32541-2370 | 2010-10-06 |
| 1538478086 | Nob Hill Medical Center, Inc. | Legal Medicine | 10098 W Mcnab Rd, Tamarac, FL 33321-1895 | 2010-10-01 |
| 1780992644 | Daniel Hunt II | Legal Medicine | 2160 Anchor Ave, Deland, FL 32720-2382 | 2010-09-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.