Individual
MRS. AMY NICOLE CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1603 72ND ST. CT. EAST, PALMETTO, FL 34221
(941) 462-0349
Mailing address
1603 72ND STREET CT E, PALMETTO, FL 34221-8370
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
239011
FL
3747P1801X
Personal Care Attendant
—
—
376K00000X
Nurse's Aide
Primary
239011
FL
Other
Enumeration date
03/10/2017
Last updated
03/10/2017
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