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1134870066
FREDERICO JOSE REIS SOARES
CHARLOTTE, NC
NPI
1134870066
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: NC 5015542)
Enumeration Date
2022-01-12
Last Update Date
2022-01-13
Business Address
FREDERICO JOSE REIS SOARES
1021 MOREHEAD MEDICAL DR
CHARLOTTE, NC 28204-2990
Phone number: 980-442-2000
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Mailing Address
FREDERICO JOSE REIS SOARES
105 W C ST
BECKLEY, WV 25801-5502
Phone number: 570-561-7901
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