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General NPI Number Information
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NPI Number | 1437137353
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Entity Type | Individual
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Provider Name | CHARLENE VARGAS MD
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Gender | Female
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 09/19/2011
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Provider Practice Location Address
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Address Line | 1653 JESS PARRISH CT
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City | TITUSVILLE
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State | FL
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Zip | 32796-2145
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Country | US
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Telephone | 321-267-5965
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Fax | 321-267-8487
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Provider Business Mailing Address
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Address Line | 1653 JESS PARRISH CT
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City | TITUSVILLE
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State | FL
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Zip | 32796-2145
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Country | US
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Telephone | 321-267-5965
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Fax | 321-267-8487
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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 | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | ME100513
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License Number State | FL
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