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General NPI Number Information
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NPI Number | 1952200081
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Entity Type | Individual
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Provider Name | HAVANA CHARLES PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 11/04/2026
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Last Update Date | 11/04/2026
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Provider Practice Location Address
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Address Line | 4423 QUEEN MARY HWY
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City | CHRISTIANSTED
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State | VI
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Zip | 00820
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Country | US
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Telephone | 340-692-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 2405 RIDGE ST
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City | NORTH MYRTLE BEACH
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State | SC
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Zip | 29582-6377
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Country | US
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Telephone | 340-692-5000
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 323
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License Number State | VI
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