Individual
JERRY CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10108 FREESIAN WAY, WELLINGTON, FL 33449-8030
(561) 714-7858
(561) 549-1207
Mailing address
10108 FREESIAN WAY, WELLINGTON, FL 33449-8030
(561) 714-7858
(561) 549-1207
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9309010
FL
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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