| Organization Name: | ST. CHARLES HEALTH & WELLNESS, INC. |
| NPI Number: | 1003109281 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARLOS M GONZALEZ (OWNER/PRESIDENT) |
| Mailing Address: | 15260 Sw 280th St Suite 105 Homestead |
| State: | FL US |
| Postal Code: | 330328185 |
| Phone Number: | 3052425331 |
| Fax Number: | 3052425334 |
| NPI Enumeration Date: | 05/22/2011 |
| NPI Last Update Date: | 05/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | CH6724 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |