Healthcare Provider Details

I. General information

NPI: 1073454914
Provider Name (Legal Business Name): NADIA NELSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 PINEWOOD LAKE CT
GREENACRES FL
33415-1402
US

IV. Provider business mailing address

1032 PINEWOOD LAKE CT
GREENACRES FL
33415-1402
US

V. Phone/Fax

Practice location:
  • Phone: 561-225-0534
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number9507405
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: