Individual
CHARITE COTIN-VALCIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
238 NW FERRIS DR, PORT ST LUCIE, FL 34983-1121
(772) 985-4122
Mailing address
238 NW FERRIS DR, PORT ST LUCIE, FL 34983-1121
(772) 985-4122
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906704
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022446600
—
FL
Enumeration date
10/01/2018
Last updated
10/01/2018
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