MEDICARE: MS. SUDLAIRE THERESA CHARLOTIN MSN, RN, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	NUCC	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073243341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUDLAIRE THERESA CHARLOTIN MSN, RN, FNP-BC

Provider Business Mailing Address
First Line	:	221 SW 1ST AVE APT 3415
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-4690
Country	:	US
Telephone Number	:	954-909-1044
Fax Number	:	754-663-4866

Provider Business Practice Location Address
First Line	:	221 SW 1ST AVE APT 3415
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-4690
Country	:	US
Telephone Number	:	954-909-1044
Fax Number	:	754-663-4866

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2022
Last Update Date	:	05/27/2026

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