Healthcare Provider Details

I. General information

NPI: 1689589798
Provider Name (Legal Business Name): CHARLOTTE BEGONIA VITALE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3419 US HIGHWAY 70 W STE 102
EFLAND NC
27243-8466
US

IV. Provider business mailing address

3419 US HIGHWAY 70 W STE 102
EFLAND NC
27243-8466
US

V. Phone/Fax

Practice location:
  • Phone: 336-792-4881
  • Fax:
Mailing address:
  • Phone: 336-792-4881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP25266
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: