Healthcare Provider Details

I. General information

NPI: 1093986770
Provider Name (Legal Business Name): CHARLOTTE COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2008
Last Update Date: 03/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1994 KINGS HWY
PT CHARLOTTE FL
33980-4214
US

IV. Provider business mailing address

514 E GRACE ST
PUNTA GORDA FL
33950-6121
US

V. Phone/Fax

Practice location:
  • Phone: 941-613-0950
  • Fax: 941-613-0959
Mailing address:
  • Phone: 941-639-1181
  • Fax: 941-639-5669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberRN 1737082
License Number StateFL

VIII. Authorized Official

Name: CHERYL LEMUNYON
Title or Position: ACCOUNTANT
Credential:
Phone: 941-833-3500