Healthcare Provider Details

I. General information

NPI: 1538080718
Provider Name (Legal Business Name): KASHAMA N CHARLES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 CORAL BEACH CIR
CASSELBERRY FL
32707-3401
US

IV. Provider business mailing address

329 CORAL BEACH CIR
CASSELBERRY FL
32707-3401
US

V. Phone/Fax

Practice location:
  • Phone: 340-277-0235
  • Fax:
Mailing address:
  • Phone: 340-277-0235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number11518
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: