Provider Demographics
NPI:1861739781
Name:CHARLES, KARLENE L (RPH)
Entity type:Individual
Prefix:MS
First Name:KARLENE
Middle Name:L
Last Name:CHARLES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 FORTUNE RD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-3993
Mailing Address - Country:US
Mailing Address - Phone:407-348-7686
Mailing Address - Fax:407-348-4790
Practice Address - Street 1:2340 FORTUNE RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-3993
Practice Address - Country:US
Practice Address - Phone:407-348-7686
Practice Address - Fax:407-348-4790
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38517183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist