Provider Demographics
NPI:1508903097
Name:GARZON, CHARLOTTE ARLETT (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:ARLETT
Last Name:GARZON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 NW 87TH PLACE
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172
Mailing Address - Country:US
Mailing Address - Phone:786-457-8882
Mailing Address - Fax:786-388-1344
Practice Address - Street 1:2406 NW 87TH PLACE
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172
Practice Address - Country:US
Practice Address - Phone:786-457-8882
Practice Address - Fax:786-388-1344
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7737111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89685AOtherBLUECROSSBLUESHIELD
FLU99187Medicare UPIN
FLU2175CMedicare ID - Type Unspecified