Individual
CHARLEMAGNE RAPHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
220 SW 38TH AVE APT 104, FORT LAUDERDALE, FL 33312-1871
(475) 268-9328
Mailing address
220 SW 38TH AVE APT 104, FORT LAUDERDALE, FL 33312-1871
(475) 268-9328
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
001358-PA
PR
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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