Individual
MR. CHARLES HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 NW 183RD ST, SUITE 400, MIAMI GARDENS, FL 33169-4537
(305) 892-4753
(305) 493-0814
Mailing address
111 NW 183RD ST, SUITE 400, MIAMI GARDENS, FL 33169-4537
(305) 892-4753
(305) 493-0814
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5162196
FL
Other
Enumeration date
11/13/2007
Last updated
11/13/2007
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