Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP9265908 | FL |
NPI | 1003213547 |
---|---|
Provider Name | Mrs. Sherley Charles |
First Address | Hollywood, FL 33024-5339 |
Second Address | Hollywood, FL 33024-5339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2014 |
Last Update Date | 27/11/2014 |