Healthcare Provider Details

I. General information

NPI: 1407741119
Provider Name (Legal Business Name): CHRISTINA-REGINE OWENS-CHARLES DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NW 16TH ST
MIAMI FL
33125-1624
US

IV. Provider business mailing address

18801 GARBO TER APT 2
BOCA RATON FL
33496-2165
US

V. Phone/Fax

Practice location:
  • Phone: 305-575-7000
  • Fax:
Mailing address:
  • Phone: 305-780-9519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberUO11687
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: