Provider Demographics
NPI:1245815968
Name:CHARMAINE HEALTH CARE LLC
Entity type:Organization
Organization Name:CHARMAINE HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MAY
Authorized Official - Middle Name:E
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:863-221-8441
Mailing Address - Street 1:122 E MAIN ST # 137
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-4655
Mailing Address - Country:US
Mailing Address - Phone:863-221-8441
Mailing Address - Fax:
Practice Address - Street 1:122 E MAIN ST # 137
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-4655
Practice Address - Country:US
Practice Address - Phone:863-221-6522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty