OrganizationActive
The Diabetic Place LLC
NPI 1104022169 · Family Nurse Practitioner · Pembroke Pines, FL
Provider details
- NPI number
- 1104022169
- Entity type
- Organization
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Shawna Charles, Nurse Practitioner(954) 990-0461
- License
- 1956772 (FL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
10472 Taft St
Pembroke Pines, FL 33026-2819
Phone: (954) 990-0461
Fax: (954) 990-0465
Street-level locationGet directions
Mailing address
Po Box 848182
Hollywood, FL 33084-0182
Registry dates
- Enumerated
- 2007-06-26
- Last updated
- 2015-03-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.