Individual
SHELLA CHARLOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, HAIR LOSS SPECI
Contact information
Practice address
1317 EDGEWATER DR # 467, ORLANDO, FL 32804-6350
(407) 914-4451
Mailing address
PO BOX 489, OCOEE, FL 34761-0489
(407) 914-4451
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
12/07/2018
Last updated
12/08/2020
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