Healthcare Provider Details

I. General information

NPI: 1780521161
Provider Name (Legal Business Name): CARLOS ANDRES PEREZ CHARTON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 DRIFTWOOD WAY UNIT 3103
NAPLES FL
34109-8982
US

IV. Provider business mailing address

3021 DRIFTWOOD WAY UNIT 3103
NAPLES FL
34109-8982
US

V. Phone/Fax

Practice location:
  • Phone: 239-306-2573
  • Fax: 239-306-2573
Mailing address:
  • Phone: 239-306-2573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number26-109
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number3100
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3100
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: