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General NPI Number Information
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NPI Number | 1639771991
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Entity Type | Individual
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Provider Name | JULBERTHY S CHARLES
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Gender | Female
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Dates
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Enumeration Date | 11/11/2020
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 9385 BOYNTON BEACH BLVD
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-4471
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Country | US
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Telephone | 617-682-5242
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Fax |
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Provider Business Mailing Address
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Address Line | 6491 PARK LN W
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City | LAKE WORTH
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State | FL
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Zip | 33449-6606
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Country | US
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Telephone | 617-682-5242
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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