Most Relevant Information
Provider Data
| NPI Number: | 1003522657 |
| Provider Name: | CHARLI ELIZABETH CUBBAGE PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | STUDENT |
Most Important Dates
| Enumeration Date: | 01/26/2023 |
| Last Updated: | 01/26/2023 |
Provider Practice Location
15415 PANAMA CITY BEACH PKWY
PANAMA CITY BEACH
FL
324135409
Practice Location Phone/Fax
| Phone: | 8505883589 |
| Fax: |
Provider Mailing Location
88 BLUE STREAM WAY APT 11302
INLET BEACH
FL
324618633
Provider Mailing Phone/Fax
| Phone: | 6017657277 |
| Fax: |