MEDICARE: DENISE CHARLES CNA

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	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1760990683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE CHARLES CNA

Provider Business Mailing Address
First Line	:	5098 ASHLEY LAKE DR
Second Line	:	1022
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3183
Country	:	US
Telephone Number	:	954-864-7123
Fax Number	:

Provider Business Practice Location Address
First Line	:	5098 ASHLEY LAKE DR
Second Line	:	1022
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3183
Country	:	US
Telephone Number	:	954-864-7123
Fax Number	:

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

Provider Enumeration Date	:	01/12/2018
Last Update Date	:	01/12/2018

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Directions to “ DENISE CHARLES CNA” Practice Location

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