Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Derek Blake Charles

Individual provider Behavior Technician · NPI 1073380481

Derek Blake Charles is a Behavior Technician in Palm Coast, Florida. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

18 Prince Kaarel Ln
Palm Coast, FL 32164-7156
Phone: (606) 213-2755
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1073380481
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 6, 2023
Last updated in NPPESDecember 6, 2023
Certification dateDecember 6, 2023
Mailing address23 Rybar Ln, Palm Coast, FL 32164-6445

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