Provider Demographics
NPI:1154183457
Name:CHARLES, NITHA (ASPECT MEDICAL)
Entity type:Individual
Prefix:
First Name:NITHA
Middle Name:
Last Name:CHARLES
Suffix:
Gender:F
Credentials:ASPECT MEDICAL
Other - Prefix:
Other - First Name:VLADIMIR
Other - Middle Name:
Other - Last Name:LAURENT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ASPECT MEDICAL TRANS
Mailing Address - Street 1:6047 KIMBERLY BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-2819
Mailing Address - Country:US
Mailing Address - Phone:954-661-2315
Mailing Address - Fax:
Practice Address - Street 1:6047 KIMBERLY BLVD STE E
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-2819
Practice Address - Country:US
Practice Address - Phone:954-661-2315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL342000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company