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NPI Code Detail

MEDICARE: LEONELLE' CHARLES

MEDICARE: LEONELLE' CHARLES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPRN11011812FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528652781
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEONELLE' CHARLES
Provider Business Mailing Address
First Line : 1600 37TH ST
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-4863
Country : US
Telephone Number : 772-778-2100
Fax Number :
Provider Business Practice Location Address
First Line : 1600 37TH ST
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-4863
Country : US
Telephone Number : 772-778-2100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2021
Last Update Date : 02/26/2021

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Directions to “ LEONELLE' CHARLES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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