Healthcare Provider Details

I. General information

NPI: 1871908749
Provider Name (Legal Business Name): PAMELA CHARNIN NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13590 S JOG RD STE 4
DELRAY BEACH FL
33446-3807
US

IV. Provider business mailing address

2394 SW 8TH AVENUE
BOYTON BEACH FL
33426
US

V. Phone/Fax

Practice location:
  • Phone: 561-396-1538
  • Fax: 561-396-1539
Mailing address:
  • Phone: 516-388-3884
  • Fax: 516-694-3783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11007211
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: