Basic Information
Provider Information
NPI: 1386678928
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALAIMO
FirstName: CHARLES
MiddleName: JOSEPH
NamePrefix: MR.
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5535 BATES ST
Address2:  
City: SEMINOLE
State: FL
PostalCode: 337727150
CountryCode: US
TelephoneNumber: 7276560151
FaxNumber:  
Practice Location
Address1: 10000 BAY PINES BLVD.
Address2:  
City: BAY PINES
State: FL
PostalCode: 33744
CountryCode: US
TelephoneNumber: 7273986661
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/10/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP2300X2596512FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care

No ID Information.


Home