Provider Demographics
NPI:1902889447
Name:MUTSCHLER, CHARLES AARON (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:AARON
Last Name:MUTSCHLER
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 1:18280 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2001
Mailing Address - Country:US
Mailing Address - Phone:786-428-3668
Mailing Address - Fax:305-932-0923
Practice Address - Street 1:18280 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33160-2001
Practice Address - Country:US
Practice Address - Phone:786-428-3668
Practice Address - Fax:305-932-0923
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2984213ES0000X, 213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
4935930001OtherDMERC
FL65789OtherBCBS
FL65789OtherBCBS
FLU91724Medicare UPIN