Djrj2

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

ME82558 Issued in FL

Legal business name

DJRJ2

Doing business as

Comprehensive Women's Health

Practice address

4225 NW American LN
Lake City, FL 32055-8841

Phone

(386) 365-3845

NPI assigned

Nov 10, 2008

Last updated

Nov 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Michael Charl3S Jr., MD

Title

Owner

Phone

(386) 365-3845

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Comprehensive Women's Health Doing business as

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226275200000",
    "number": "1164676771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 805",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320560805",
            "telephone_number": "386-755-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 NW AMERICAN LN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320558841",
            "telephone_number": "386-365-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DJRJ2",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-10",
        "last_updated": "2008-11-10",
        "status": "A",
        "authorized_official_last_name": "CHARL3S",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-365-3845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME82558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274840100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive Women's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Lee Devries, R.D.
• Luz S Diaz, PT
• Danielle Dinger, LCSW
• Kathy Dix
• Lakiesha Dixon
• DM Rehab Core LLC
• Rolando Dominguez Mustafa, M.D.
• Don Houston, Inc. (DeSoto Drug Store)
• Brianna Lane Donaldson
• Scott G Donelenko, R.PH.

• Obstetrics & Gynecology Physician in Lake City, FL
• Providers in Lake City, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2008; 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.