Provider Demographics
NPI:1538399787
Name:CHARLES, ENOC (RRT)
Entity type:Individual
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First Name:ENOC
Middle Name:
Last Name:CHARLES
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
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Mailing Address - Street 1:14699 NE 18TH AVE
Mailing Address - Street 2:APT 1F
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-1427
Mailing Address - Country:US
Mailing Address - Phone:786-879-6897
Mailing Address - Fax:
Practice Address - Street 1:14699 NE 18TH AVE
Practice Address - Street 2:APT 1F
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-1427
Practice Address - Country:US
Practice Address - Phone:786-879-6897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLRT10132227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered