Provider Demographics
NPI:1225224868
Name:JALOVI, CHARLENE E (PAC)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:E
Last Name:JALOVI
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:CHARLENE
Other - Middle Name:E
Other - Last Name:FINLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:1020 LAKE SUMTER LNDG
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-2699
Mailing Address - Country:US
Mailing Address - Phone:352-674-8905
Mailing Address - Fax:352-674-8901
Practice Address - Street 1:2910 BROWNWOOD BLVD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163-2032
Practice Address - Country:US
Practice Address - Phone:352-674-1790
Practice Address - Fax:352-674-8990
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9108759363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20339600Medicaid