Provider Demographics
NPI:1790954311
Name:BORRERO, CHARIN MARIE (RPAC)
Entity Type:Individual
Prefix:MS
First Name:CHARIN
Middle Name:MARIE
Last Name:BORRERO
Suffix:
Gender:F
Credentials:RPAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 PLEASURE HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-2709
Mailing Address - Country:US
Mailing Address - Phone:757-318-6900
Mailing Address - Fax:757-318-6901
Practice Address - Street 1:2017 PLEASURE HOUSE RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-2709
Practice Address - Country:US
Practice Address - Phone:757-318-6900
Practice Address - Fax:757-318-6901
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011006363AM0700X
VA0110006961363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical