Provider Demographics
NPI:1548261506
Name:CHAPEL, CHARLES PAUL (DPM)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:PAUL
Last Name:CHAPEL
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 1:12084 CORTEZ BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-7371
Mailing Address - Country:US
Mailing Address - Phone:352-684-1444
Mailing Address - Fax:352-515-0920
Practice Address - Street 1:12084 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-7371
Practice Address - Country:US
Practice Address - Phone:352-684-1444
Practice Address - Fax:352-515-0920
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP02751213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL480031580OtherRAILROAD MEDICARE
FL65693OtherB/C
FL340167700Medicaid
FL480034411OtherRAILROAD MEDICARE
FLE2710ZOtherMEDICARE
FL1400257OtherGHI
FL480034411OtherRAILROAD MEDICARE
FL4658410001Medicare NSC
U00138Medicare UPIN