Provider Demographics
NPI:1013532142
Name:CHARITE, CAMITA CHARITE (NP)
Entity Type:Individual
Prefix:
First Name:CAMITA
Middle Name:CHARITE
Last Name:CHARITE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 W YORK CT
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-4636
Mailing Address - Country:US
Mailing Address - Phone:561-396-4806
Mailing Address - Fax:
Practice Address - Street 1:106 W YORK CT
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-4636
Practice Address - Country:US
Practice Address - Phone:156-139-6480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11007462363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily