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General NPI Number Information
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NPI Number | 1356018154
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Entity Type | Individual
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Provider Name | CHARLOTTE HOMME MD
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Gender | Female
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Dates
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Enumeration Date | 08/27/2021
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Last Update Date | 08/28/2021
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Provider Practice Location Address
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Address Line | 6259 SUNSET DR APT 1H
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-8827
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Country | US
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Telephone | 786-575-7705
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Fax |
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Provider Business Mailing Address
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Address Line | 6259 SUNSET DR
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-8801
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Country | US
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Telephone |
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | X631808162340
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License Number State | FL
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