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General NPI Number Information
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NPI Number | 1073628491
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Entity Type | Individual
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Provider Name | JERRY CHARLES CHARNECO MD
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Gender | Male
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 63 CALLE MUNOZ MARIN
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City | HUMACAO
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State | PR
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Zip | 00791-3646
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Country | US
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Telephone | 787-850-7900
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Fax | 787-850-7900
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Provider Business Mailing Address
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Address Line | 63 AVE MUNOZ MARIN
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-850-7900
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Fax | 787-850-7900
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 4249
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License Number State | PR
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