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General NPI Number Information
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NPI Number | 1205108495
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Entity Type | Individual
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Provider Name | LYONIE HERODIA CHARLES ARNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/02/2012
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 860 US 1 STE 102C
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City | NORTH PALM BEACH
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State | FL
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Zip | 33408-3879
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Country | US
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Telephone | 561-282-3924
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Fax | 844-687-7509
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Provider Business Mailing Address
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Address Line | 11054 57TH RD N
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-8852
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Country | US
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Telephone | 561-714-0372
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9239497
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License Number State | FL
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