Individual provider Active NPI

Charite Octave

  • Contractor
  • Lauderdale Lakes, FL
National Provider Identifier
1124553771
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
3390 NW 30TH St Apt 10
Lauderdale Lakes, FL 33311-1136
Phone
(772) 882-2275
NPI assigned
Apr 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Primary

Addresses

Primary practice location

3390 NW 30TH St Apt 10
Lauderdale Lakes, FL 33311-1136

Mailing address

3390 NW 30TH St Apt 10
Lauderdale Lakes, FL 33311-1136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1124553771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 NW 30TH ST APT 10",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333111136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 NW 30TH ST APT 10",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333111136",
            "telephone_number": "772-882-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCTAVE",
        "first_name": "CHARITE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.