Healthcare Provider Details

I. General information

NPI: 1467316497
Provider Name (Legal Business Name): MIREILLE LOUIS CHARLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1865 NE 171ST ST
NORTH MIAMI BEACH FL
33162-3003
US

IV. Provider business mailing address

1865 NE 171ST ST
NORTH MIAMI BEACH FL
33162-3003
US

V. Phone/Fax

Practice location:
  • Phone: 305-799-7503
  • Fax:
Mailing address:
  • Phone: 305-799-7503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: