Provider Demographics
NPI:1518365360
Name:CHARLES, REINETTE NATASHA (NP)
Entity Type:Individual
Prefix:MS
First Name:REINETTE
Middle Name:NATASHA
Last Name:CHARLES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:600 W. HILLSBORO BLVD
Mailing Address - Street 2:STE 110
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441
Mailing Address - Country:US
Mailing Address - Phone:754-224-3006
Mailing Address - Fax:
Practice Address - Street 1:600 W. HILLSBORO BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441
Practice Address - Country:US
Practice Address - Phone:954-862-7082
Practice Address - Fax:954-843-7313
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DELB0000257363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health