Provider Demographics
NPI:1427121615
Name:CHAMAS, CHARLES E (DPM)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:E
Last Name:CHAMAS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4368 NORTH ATLANTIC AVENUE
Mailing Address - Street 2:
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-3656
Mailing Address - Country:US
Mailing Address - Phone:321-783-2702
Mailing Address - Fax:321-783-3599
Practice Address - Street 1:4368 NORTH ATLANTIC AVENUE
Practice Address - Street 2:
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-3656
Practice Address - Country:US
Practice Address - Phone:321-783-2702
Practice Address - Fax:321-783-3599
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP01366213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T55529Medicare UPIN
FL87749Medicare ID - Type Unspecified