Provider Demographics
NPI:1205284155
Name:CHARLES, RENETTE (ARNP)
Entity type:Individual
Prefix:
First Name:RENETTE
Middle Name:
Last Name:CHARLES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
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Mailing Address - Street 1:425 W COLONIAL DR STE 303
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6863
Mailing Address - Country:US
Mailing Address - Phone:321-332-6947
Mailing Address - Fax:407-286-4515
Practice Address - Street 1:13045 SUMMERFIELD SQUARE DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-7402
Practice Address - Country:US
Practice Address - Phone:813-672-1385
Practice Address - Fax:813-672-8904
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2024-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9239848363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care