Individual provider Active NPI

Charito Alley, PA-C

  • Medical Physician Assistant
  • Altamonte Springs, FL
National Provider Identifier
1730453523
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9106054 Issued in FL
Practice address
683 Douglas Ave
Suite 101
Altamonte Springs, FL 32714-0913
Phone
(407) 478-1510
Fax
(407) 478-1512
NPI assigned
Feb 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9106054 FL Primary

Addresses

Primary practice location

683 Douglas Ave
Suite 101
Altamonte Springs, FL 32714-0913

Mailing address

683 Douglas Ave
Suite 101
Altamonte Springs, FL 32714-0913
Phone (407) 478-1510

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA9106054FLMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1730453523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "683 DOUGLAS AVE",
            "address_2": "SUITE 101",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327140913",
            "telephone_number": "407-478-1510",
            "fax_number": "407-478-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 DOUGLAS AVE",
            "address_2": "SUITE 101",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327140913",
            "telephone_number": "407-478-1510",
            "fax_number": "407-478-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEY",
        "first_name": "CHARITO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-27",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9106054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2012; 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.