Provider Demographics
NPI:1124165584
Name:CHURAN, CAROLE
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:
Last Name:CHURAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 KAPOK CRES
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4747
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2532 W INDIANTOWN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3935
Practice Address - Country:US
Practice Address - Phone:561-748-5430
Practice Address - Fax:561-748-5442
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA14681225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant