Provider Demographics
NPI:1720873524
Name:CHARLES, CHARLYNE
Entity type:Individual
Prefix:
First Name:CHARLYNE
Middle Name:
Last Name: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 1:938 NORTHERN DR APT K
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-2033
Mailing Address - Country:US
Mailing Address - Phone:561-246-2405
Mailing Address - Fax:561-246-2405
Practice Address - Street 1:938 NORTHERN DR APT K
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-2033
Practice Address - Country:US
Practice Address - Phone:561-246-2405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide