Provider Demographics
NPI:1508587213
Name:JEAN-CHARLES, VLADIMIR (FNP)
Entity Type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:
Last Name:JEAN-CHARLES
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7071 IVY CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-9415
Mailing Address - Country:US
Mailing Address - Phone:561-903-5897
Mailing Address - Fax:
Practice Address - Street 1:4379 WILLOW POND RD APT B
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-8261
Practice Address - Country:US
Practice Address - Phone:561-903-5897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11020449363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily