Provider Demographics
NPI:1013119387
Name:LEPANE, CHARLENE ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:CHARLENE
Middle Name:ANN
Last Name:LEPANE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400 CELEBRATION PL STE A360
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-4970
Mailing Address - Country:US
Mailing Address - Phone:407-303-4829
Mailing Address - Fax:407-303-4851
Practice Address - Street 1:400 CELEBRATION PL STE A360
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-4970
Practice Address - Country:US
Practice Address - Phone:407-303-4829
Practice Address - Fax:407-303-4851
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9921207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFE664ZMedicare UPIN