Provider Demographics
NPI:1366199556
Name:CHARLES, SHERLINE
Entity type:Individual
Prefix:
First Name:SHERLINE
Middle Name:
Last Name:CHARLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHERLINE
Other - Middle Name:
Other - Last Name:CHARLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:902 SUNSHINE WAY SW
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-2020
Mailing Address - Country:US
Mailing Address - Phone:863-509-2634
Mailing Address - Fax:863-582-9908
Practice Address - Street 1:902 SUNSHINE WAY SW
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-2020
Practice Address - Country:US
Practice Address - Phone:863-509-2634
Practice Address - Fax:863-582-9908
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-07
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)