Individual
CHARLES GAINES SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15518 SW 36TH TER, MIAMI, FL 33185-4811
(786) 299-5922
Mailing address
15518 SW 36 TR, MIAMI, FL 33185
(786) 299-5922
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
01/29/2014
Last updated
01/29/2014
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