Healthcare Provider Details

I. General information

NPI: 1629485669
Provider Name (Legal Business Name): NADIA NELSON- CALIXTE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NADIA NELSON CALISTE RN

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 07/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 WASHINGTON ST SUITE 500
HOLLYWOOD FL
33021
US

IV. Provider business mailing address

3700 WASHINGTON ST SUITE 500
HOLLYWOOD FL
33021
US

V. Phone/Fax

Practice location:
  • Phone: 954-894-3083
  • Fax: 954-894-3323
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP2752602
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2752602
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2752602
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number2752602
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: