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NPI Code Detail

MEDICARE: DR. RONALD DAVID NELSON PHARM.D., BCPP

MEDICARE: DR. RONALD DAVID NELSON PHARM.D., BCPP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1300XPsychiatric PharmacistPH00040757WA
21835P1300XPsychiatric Pharmacist1163603MN

General Provider Information

NPI Number : 1205821808
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RONALD DAVID NELSON PHARM.D., BCPP
Provider Business Mailing Address
First Line : 9 S PALMWAY AVE
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32955-2841
Country : US
Telephone Number : 206-850-6380
Fax Number : 321-637-3570
Provider Business Practice Location Address
First Line : 2900 VETERANS WAY
Second Line :
City : VIERA
State : FL
Zip : 32940-8007
Country : US
Telephone Number : 321-637-3788
Fax Number : 321-637-3570
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2005
Last Update Date : 01/04/2011

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