Provider Demographics
NPI:1881295780
Name:ADAIR, CHARMAINE LASHA
Entity type:Individual
Prefix:
First Name:CHARMAINE
Middle Name:LASHA
Last Name:ADAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHARMAINE
Other - Middle Name:LASHA
Other - Last Name:HOUSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:3034 SERA BELLA WAY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-9338
Mailing Address - Country:US
Mailing Address - Phone:407-973-5295
Mailing Address - Fax:
Practice Address - Street 1:1601 S MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32307-3105
Practice Address - Country:US
Practice Address - Phone:850-599-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009682363LA2200X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology