Provider Demographics
NPI:1447213467
Name:YOWELL, CHARLES WARREN (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:WARREN
Last Name:YOWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 WINTER GARDEN VINELAND RD
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-6098
Mailing Address - Country:US
Mailing Address - Phone:321-842-7888
Mailing Address - Fax:321-842-9338
Practice Address - Street 1:5151 WINTER GARDEN VINELAND RD
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-6098
Practice Address - Country:US
Practice Address - Phone:321-842-7888
Practice Address - Fax:321-842-9338
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36917208800000X
FLME95784208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022692400Medicaid
SC975031OtherWELLCARE
SC280036OtherMEDCOST