Dale Rafael Charneco

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME15741 Issued in FL

Practice address

2055 Professional Center Dr
Orange Park, FL 32073-4461

Phone

(904) 276-4500

Fax

(904) 276-4160

NPI assigned

Aug 1, 2005

Last updated

Jan 15, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1740281781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-3660",
            "fax_number": "904-244-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 PROFESSIONAL CENTER DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734461",
            "telephone_number": "904-276-4500",
            "fax_number": "904-276-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARNECO",
        "first_name": "DALE",
        "middle_name": "RAFAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME15741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00121400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "16812Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashlee Kyler Channell
• Cassandra Grace Chappell
• Charis Home Care Services LLC
• Charles H. Hudgins
• Aimee Charles, MSN, PMHNP-BC
• Mansi Chaturvedi
• Alex Jinbin Chen, DO
• Aaliyah Cherry
• Cheryl King Counseling
• Jeffrey Bruce Chesler I, MD

• Dermatology Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.