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General NPI Number Information
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NPI Number | 1508338567
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Entity Type | Individual
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Provider Name | JERRY CHARLES JR. NP
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Gender | Male
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Dates
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Enumeration Date | 12/31/2018
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 2161 PALM BEACH LAKES BLVD STE 208
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-6611
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Country | US
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Telephone | 561-899-3199
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Fax |
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Provider Business Mailing Address
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Address Line | 1340 BOYLSTON ST
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City | BOSTON
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State | MA
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Zip | 02215-4302
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Country | US
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Telephone | 617-267-0900
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Fax | 617-867-8646
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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 | RN2348883
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License Number State | MA
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