Provider Demographics
NPI:1285707828
Name:FRANSON, CHARLES JAMES JR (DO)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:JAMES
Last Name:FRANSON
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S LAWRENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:KEYSTONE HEIGHTS
Mailing Address - State:FL
Mailing Address - Zip Code:32656-9215
Mailing Address - Country:US
Mailing Address - Phone:352-473-9373
Mailing Address - Fax:352-473-0037
Practice Address - Street 1:345 W MADISON ST
Practice Address - Street 2:
Practice Address - City:STARKE
Practice Address - State:FL
Practice Address - Zip Code:32091-3923
Practice Address - Country:US
Practice Address - Phone:904-964-5455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7960208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258627400Medicaid
FLH14144Medicare UPIN