Individual
CHARMAINE MUIR GAYNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5211 NW MAYFIELD LN, PORT ST LUCIE, FL 34983-5348
(772) 446-4747
Mailing address
5211 NW, MAYFIELD LANE, PORT ST LUCIE, FL 34983
(772) 446-4747
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
376K00000X
Nurse's Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004701500
—
FL
Enumeration date
03/16/2016
Last updated
03/28/2016
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