Individual
MRS. CHARLENE MATHURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
200 PARK PLACE BLVD, KISSIMMEE, FL 34741-2344
(407) 846-0765
(407) 846-0738
Mailing address
4433 LAKE CALABAY DR, ORLANDO, FL 32837-5468
(407) 846-0765
(407) 846-0738
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS34052
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS34052
PHARMACIST LICENSE
FL
Enumeration date
11/02/2006
Last updated
07/08/2007
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