Healthcare Provider Details

I. General information

NPI: 1013532142
Provider Name (Legal Business Name): CAMITA CHARITE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 TOWNE CENTER BLVD
SANFORD FL
32771-7407
US

IV. Provider business mailing address

1676 SWEETWATER WEST CIR
APOPKA FL
32712-2485
US

V. Phone/Fax

Practice location:
  • Phone: 407-200-0547
  • Fax: 407-205-0803
Mailing address:
  • Phone: 561-396-4806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11007462
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: