Moore, Charlene K

Moore, Charlene K is an individual health care provider with primary practice located at 160 Nw Central Park Plz Ste 103 , Port St Lucie FL 34986-1825. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Moore, Charlene K can be contacted via phone (772) 212-7636.

Contact Information

Primary practice address
160 Nw Central Park Plz Ste 103 Port St Lucie FL 34986-1825
Phone: (772) 212-7636
Fax: (772) 212-7625
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 50002517 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9107673 Florida

Profile Details

NPI number 1639325376
LBN Legal business name Moore, Charlene K
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2008
Last updated Dec 23rd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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