Provider Demographics
NPI:1295524163
Name:CHARLES, ANABELLE (RD)
Entity type:Individual
Prefix:
First Name:ANABELLE
Middle Name:
Last Name:CHARLES
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6522 SW 85TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-9007
Mailing Address - Country:US
Mailing Address - Phone:340-998-8151
Mailing Address - Fax:
Practice Address - Street 1:6522 SW 85TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-9007
Practice Address - Country:US
Practice Address - Phone:340-998-8151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD006654133V00000X
FLND13961133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered