Provider Demographics
NPI:1306886635
Name:KILO, CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
Last Name:KILO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2675 WINKLER AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:239-599-2625
Practice Address - Street 1:1495 PINE RIDGE RD STE 4
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2113
Practice Address - Country:US
Practice Address - Phone:239-594-5456
Practice Address - Fax:239-592-5456
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85812207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40916FOtherBLUE CROSS
FL265402400Medicaid
FL84058OtherFL BC
FL265402400Medicaid
FL84058OtherFL BC