Provider Demographics
NPI:1194524405
Name:JEAN- CHARLES, MILIENNE
Entity type:Individual
Prefix:
First Name:MILIENNE
Middle Name:
Last Name:JEAN- CHARLES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6341 MAGNOLIA TRAILS LN
Mailing Address - Street 2:
Mailing Address - City:GIBSONTON
Mailing Address - State:FL
Mailing Address - Zip Code:33534-3002
Mailing Address - Country:US
Mailing Address - Phone:813-388-3920
Mailing Address - Fax:
Practice Address - Street 1:6341 MAGNOLIA TRAILS LN
Practice Address - Street 2:
Practice Address - City:GIBSONTON
Practice Address - State:FL
Practice Address - Zip Code:33534-3002
Practice Address - Country:US
Practice Address - Phone:813-388-3920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker