Provider Demographics
NPI:1619069309
Name:CHARLOT, JEAN-BAPTISTE LUC (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN-BAPTISTE
Middle Name:LUC
Last Name:CHARLOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8260 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138-3808
Mailing Address - Country:US
Mailing Address - Phone:305-797-9555
Mailing Address - Fax:305-463-6693
Practice Address - Street 1:8260 NE 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-3808
Practice Address - Country:US
Practice Address - Phone:305-797-9555
Practice Address - Fax:305-463-6693
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL36586207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLB76062Medicare UPIN