Individual
MARISELA CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1096
(305) 585-5584
Mailing address
1611 NW 12TH AVE, MIAMI, FL 33136-1096
(305) 585-5584
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
11022969
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11022969
FL
Other
Enumeration date
09/28/2023
Last updated
04/01/2024
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