Provider Demographics
NPI:1689780488
Name:CHARLOTTE COUNTY BOARD OF COUNTY COMMISSIONERS
Entity Type:Organization
Organization Name:CHARLOTTE COUNTY BOARD OF COUNTY COMMISSIONERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:V
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:941-833-6500
Mailing Address - Street 1:512 E GRACE ST
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-6121
Mailing Address - Country:US
Mailing Address - Phone:941-833-6500
Mailing Address - Fax:941-833-6565
Practice Address - Street 1:512 E GRACE ST
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-6121
Practice Address - Country:US
Practice Address - Phone:941-833-6500
Practice Address - Fax:941-833-6565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024910602Medicare ID - Type Unspecified
FL024910601Medicare ID - Type Unspecified