Provider Demographics
NPI:1598775389
Name:CANALI, CHARLENE A (DC)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:A
Last Name:CANALI
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 1:6601 SW 80TH ST
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4661
Mailing Address - Country:US
Mailing Address - Phone:305-284-7223
Mailing Address - Fax:
Practice Address - Street 1:6601 SW 80TH ST
Practice Address - Street 2:SUITE 200A
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4661
Practice Address - Country:US
Practice Address - Phone:305-284-7223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4876111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT38556Medicare UPIN
FLK5045Medicare PIN