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NPI Code Detail

MEDICARE: JEFFRY CHARLEMAGNE

MEDICARE:   JEFFRY  CHARLEMAGNE
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
1106S00000XBehavior TechnicianRBT-24-383835FL

General Provider Information

NPI Number : 1285454959
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFRY CHARLEMAGNE
Provider Business Mailing Address
First Line : 10371 SW 168TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33157-4251
Country : US
Telephone Number : 786-675-1301
Fax Number :
Provider Business Practice Location Address
First Line : 10371 SW 168TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33157-4251
Country : US
Telephone Number : 786-675-1301
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2024
Last Update Date : 10/16/2024

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Directions to “ JEFFRY CHARLEMAGNE ” Practice Location

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