Lacey Mikelle Charbonneau, PHARMD, BCGP

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS53336 Issued in FL

Practice address

400 6TH St NW
Winter Haven, FL 33881-4062

Phone

(904) 993-3592

NPI assigned

Jan 9, 2021

Last updated

Aug 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1083202584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 6TH ST NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 6TH ST NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814062",
            "telephone_number": "904-993-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARBONNEAU",
        "first_name": "LACEY",
        "middle_name": "MIKELLE",
        "credential": "PHARMD, BCGP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-09",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS53336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori-Anne Champagnie
• Karthic Chandran, MD
• Kollagunta Sreenivasa Chandrasekhar, M.D.
• Allison Marie Chapman, OD
• Ann Chapman, MA, CAP, RMHCI
• Madeline Charles, CNM
• Sherline Charles
• Bertha Chavis
• Deepu Cherian
• Cherish Hearts Homecare LLC

• Pharmacist in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.