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Contact Information

CHARLENE A WILSON, PA-C
5955 PONCE DE LEON BLVD
CORAL GABLES, FL33146-2423
 Phone: 305-661-1515
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for CHARLENE A WILSON · (Female)

NPI Number 1518465772
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 01/23/2018
Last updated 04/03/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • FL License # PA9111001
  • FL Other PA9111001 FLORIDA DEPARTMENT OF HEALTH
Hospital affiliation(s)
  • HOLY CROSS HOSPITAL INC - (Acute Care)
    4725 N FEDERAL HWY
    FORT LAUDERDALE, FL 33308
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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