Provider Demographics
NPI:1326785981
Name:KINSLER, CHARLENA C
Entity Type:Individual
Prefix:
First Name:CHARLENA
Middle Name:C
Last Name:KINSLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5593
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-5593
Mailing Address - Country:US
Mailing Address - Phone:352-402-0005
Mailing Address - Fax:
Practice Address - Street 1:6175 NW 130TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34482-1755
Practice Address - Country:US
Practice Address - Phone:352-402-0005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL690567696Medicaid